Provider Demographics
NPI:1720773732
Name:MACBRIAN, LAUREL LEA (MED)
Entity Type:Individual
Prefix:
First Name:LAUREL
Middle Name:LEA
Last Name:MACBRIAN
Suffix:
Gender:F
Credentials:MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19 MAIN RD
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:MA
Mailing Address - Zip Code:01085-9532
Mailing Address - Country:US
Mailing Address - Phone:413-210-2758
Mailing Address - Fax:
Practice Address - Street 1:2 MECHANIC ST STE 1-6
Practice Address - Street 2:
Practice Address - City:EASTHAMPTON
Practice Address - State:MA
Practice Address - Zip Code:01027-1562
Practice Address - Country:US
Practice Address - Phone:413-540-1234
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-06
Last Update Date:2023-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health