Provider Demographics
NPI:1538499660
Name:CINA, BRIAN JOSEPH (LICSW)
Entity Type:Individual
Prefix:MR
First Name:BRIAN
Middle Name:JOSEPH
Last Name:CINA
Suffix:
Gender:M
Credentials:LICSW
Other - Prefix:
Other - First Name:BRIAN
Other - Middle Name:
Other - Last Name:CINA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LICSW
Mailing Address - Street 1:12 1/2 ISHAM ST
Mailing Address - Street 2:
Mailing Address - City:BURLINGTON
Mailing Address - State:VT
Mailing Address - Zip Code:05401-8519
Mailing Address - Country:US
Mailing Address - Phone:802-233-9131
Mailing Address - Fax:
Practice Address - Street 1:200 MAIN ST
Practice Address - Street 2:STE 8
Practice Address - City:BURLINGTON
Practice Address - State:VT
Practice Address - Zip Code:05401-8350
Practice Address - Country:US
Practice Address - Phone:802-233-9131
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-12
Last Update Date:2019-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT08900611711041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical