Provider Demographics
NPI:1518030824
Name:MACKENNA-RICE, BRIAN (LMHC, LADC I)
Entity Type:Individual
Prefix:MR
First Name:BRIAN
Middle Name:
Last Name:MACKENNA-RICE
Suffix:
Gender:M
Credentials:LMHC, LADC I
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:338 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:WAKEFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01880-5013
Mailing Address - Country:US
Mailing Address - Phone:781-246-2010
Mailing Address - Fax:781-246-1448
Practice Address - Street 1:338 MAIN ST
Practice Address - Street 2:
Practice Address - City:WAKEFIELD
Practice Address - State:MA
Practice Address - Zip Code:01880-5013
Practice Address - Country:US
Practice Address - Phone:781-246-2010
Practice Address - Fax:781-246-1448
Is Sole Proprietor?:No
Enumeration Date:2006-11-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA81101YA0400X
MA4084101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Not Answered101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health