Provider Demographics
NPI:1083245005
Name:BRESNAHAN, HOPE ALINE (LICSW)
Entity Type:Individual
Prefix:
First Name:HOPE
Middle Name:ALINE
Last Name:BRESNAHAN
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21 TOTMAN ST
Mailing Address - Street 2:
Mailing Address - City:QUINCY
Mailing Address - State:MA
Mailing Address - Zip Code:02169-7564
Mailing Address - Country:US
Mailing Address - Phone:617-845-0546
Mailing Address - Fax:617-745-0052
Practice Address - Street 1:21 TOTMAN ST
Practice Address - Street 2:
Practice Address - City:QUINCY
Practice Address - State:MA
Practice Address - Zip Code:02169-7564
Practice Address - Country:US
Practice Address - Phone:617-845-0546
Practice Address - Fax:617-745-0052
Is Sole Proprietor?:No
Enumeration Date:2020-01-29
Last Update Date:2021-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1236701041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical