Mark F Bryan
Individual provider Active NPI Community/Behavioral Health Agency · Wakefield, MA
NPI 1356974091 · NPPES record last updated Feb 21, 2020
Key facts
- NPI
- 1356974091
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Community/Behavioral Health Agency 251S00000X
- Practice address
- 37 Water St
Wakefield, MA 01880-3058 - Phone
- (781) 851-2648
- NPI assigned
- Feb 21, 2020
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community/Behavioral Health Agency | 251S00000X | Yes |
Addresses
Primary practice location
37 Water St
Wakefield, MA 01880-3058
Mailing address
45 Avon St Apt 3
Wakefield, MA 01880-2585
Phone (781) 568-9001
Other providers in Wakefield, MA
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- Brown Dog Therapy and Wellness, LLC
- Evangeline Brown
- Matthew W Brown
- Davis Bu
- Courtney Bua
- Brittany Alyson Buckley-Shelton
- Kassidy Bumford
- Laura Burbine
All providers in Wakefield, MA · Community/Behavioral Health Agency in Massachusetts
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 21, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.