Provider Demographics
NPI:1457614042
Name:MCCARTIN, BRIAN E
Entity Type:Individual
Prefix:
First Name:BRIAN
Middle Name:E
Last Name:MCCARTIN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:BRIAN
Other - Middle Name:E
Other - Last Name:MCCARTIN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MA
Mailing Address - Street 1:155 WEST DUMMERSTON
Mailing Address - Street 2:
Mailing Address - City:WEST DUMMERSTON
Mailing Address - State:VT
Mailing Address - Zip Code:05357
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:155 WEST STREET
Practice Address - Street 2:
Practice Address - City:WEST DUMMERSTON
Practice Address - State:VT
Practice Address - Zip Code:05357
Practice Address - Country:US
Practice Address - Phone:802-275-5099
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-19
Last Update Date:2012-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor