Provider Demographics
NPI:1063667574
Name:PLANTE, BRENDAN JAMES (MED)
Entity Type:Individual
Prefix:
First Name:BRENDAN
Middle Name:JAMES
Last Name:PLANTE
Suffix:
Gender:M
Credentials:MED
Other - Prefix:
Other - First Name:JAMES
Other - Middle Name:JOSEPH
Other - Last Name:PLANTE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:186 BEDFORD ST.
Mailing Address - Street 2:ELIOT COMMUNITY HUMAN SERVICE INC.
Mailing Address - City:LEXINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:02420
Mailing Address - Country:US
Mailing Address - Phone:781-861-0890
Mailing Address - Fax:781-861-0899
Practice Address - Street 1:1 PRINCE ST
Practice Address - Street 2:
Practice Address - City:NORTH HAMPTON
Practice Address - State:MA
Practice Address - Zip Code:01060
Practice Address - Country:US
Practice Address - Phone:413-587-6296
Practice Address - Fax:413-587-5333
Is Sole Proprietor?:No
Enumeration Date:2008-11-25
Last Update Date:2008-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor