Provider Demographics
NPI:1720127574
Name:BRAINERD, LAWRENCE S (MSW)
Entity Type:Individual
Prefix:
First Name:LAWRENCE
Middle Name:S
Last Name:BRAINERD
Suffix:
Gender:M
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:59 CHESTER RD
Mailing Address - Street 2:
Mailing Address - City:BLANDFORD
Mailing Address - State:MA
Mailing Address - Zip Code:01008-9520
Mailing Address - Country:US
Mailing Address - Phone:413-848-2028
Mailing Address - Fax:
Practice Address - Street 1:503 STATE ST
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:MA
Practice Address - Zip Code:01109-4101
Practice Address - Country:US
Practice Address - Phone:413-733-6661
Practice Address - Fax:413-733-7841
Is Sole Proprietor?:No
Enumeration Date:2007-02-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical