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Organization

BRIEF THERAPY ASSOCIATES

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MS. MARILYN T. BRONZI LCSW (PRESIDENT)
(207) 671-2373
Entity
Organization

Contact information

Practice address
95 INDIA ST, PORTLAND, ME 04101-4250
(207) 672-2373
(207) 773-6207
Mailing address
PO BOX 14, SOUTH FREEPORT, ME 04078-0014
(207) 671-2373
(207) 773-6207

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LC4088
ME

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0004665
MEDICARE PROVIDER TRANSACTION ACCESS NUMBER
ME
01
016598
ANTHEM
ME
01
1032675
CIGNA
ME
01
7853446
AETNA
ME
01
81669
UNITED BEHAVIORAL HEALTH
ME
Enumeration date
05/11/2006
Last updated
04/08/2009
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