Provider Demographics
NPI:1467519348
Name:WARNER, VIVIANE MARAL (LICSW)
Entity Type:Individual
Prefix:MRS
First Name:VIVIANE
Middle Name:MARAL
Last Name:WARNER
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 1:17 INNERBELT ROAD
Mailing Address - Street 2:
Mailing Address - City:SOMERVILLE
Mailing Address - State:MA
Mailing Address - Zip Code:02143
Mailing Address - Country:US
Mailing Address - Phone:617-629-6790
Mailing Address - Fax:617-629-0010
Practice Address - Street 1:17 INNERBELT ROAD
Practice Address - Street 2:
Practice Address - City:SOMERVILLE
Practice Address - State:MA
Practice Address - Zip Code:02143
Practice Address - Country:US
Practice Address - Phone:617-629-6790
Practice Address - Fax:617-629-0010
Is Sole Proprietor?:No
Enumeration Date:2007-01-02
Last Update Date:2018-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor