Provider Demographics
NPI:1407375678
Name:BROPHY, CARRIE ANNE
Entity Type:Individual
Prefix:
First Name:CARRIE
Middle Name:ANNE
Last Name:BROPHY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 WASHINGTON ST STE 106
Mailing Address - Street 2:
Mailing Address - City:BRAINTREE
Mailing Address - State:MA
Mailing Address - Zip Code:02184-4764
Mailing Address - Country:US
Mailing Address - Phone:781-817-6427
Mailing Address - Fax:781-817-6681
Practice Address - Street 1:400 WASHINGTON ST STE 106
Practice Address - Street 2:
Practice Address - City:BRAINTREE
Practice Address - State:MA
Practice Address - Zip Code:02184-4764
Practice Address - Country:US
Practice Address - Phone:781-817-6427
Practice Address - Fax:781-817-6681
Is Sole Proprietor?:No
Enumeration Date:2017-09-19
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA499582101YS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YS0200XBehavioral Health & Social Service ProvidersCounselorSchool