Provider Demographics
NPI:1265571343
Name:BIENVENUE, MARCY MARIE (MA)
Entity type:Individual
Prefix:
First Name:MARCY
Middle Name:MARIE
Last Name:BIENVENUE
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:MARCY
Other - Middle Name:MARIE
Other - Last Name:RICHER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMHC
Mailing Address - Street 1:478 E NEW LENOX RD
Mailing Address - Street 2:
Mailing Address - City:PITTSFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01201-8313
Mailing Address - Country:US
Mailing Address - Phone:413-395-9673
Mailing Address - Fax:
Practice Address - Street 1:333 EAST ST
Practice Address - Street 2:BRIEN CENTER
Practice Address - City:PITTSFIELD
Practice Address - State:MA
Practice Address - Zip Code:01201-5312
Practice Address - Country:US
Practice Address - Phone:413-499-0412
Practice Address - Fax:413-499-0995
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA6252101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health