Provider Demographics
NPI:1679188312
Name:SANTANIELLO, BRIENNA NICOLE (MS, LMHC)
Entity type:Individual
Prefix:
First Name:BRIENNA
Middle Name:NICOLE
Last Name:SANTANIELLO
Suffix:
Gender:F
Credentials:MS, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:109 OAK ST STE 201
Mailing Address - Street 2:
Mailing Address - City:NEWTON
Mailing Address - State:MA
Mailing Address - Zip Code:02464-1493
Mailing Address - Country:US
Mailing Address - Phone:617-977-5372
Mailing Address - Fax:617-458-8644
Practice Address - Street 1:109 OAK ST STE 201
Practice Address - Street 2:
Practice Address - City:NEWTON
Practice Address - State:MA
Practice Address - Zip Code:02464-1493
Practice Address - Country:US
Practice Address - Phone:617-977-5372
Practice Address - Fax:617-458-8644
Is Sole Proprietor?:No
Enumeration Date:2020-09-10
Last Update Date:2024-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA101YS0200X
MALMHC10000857101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YS0200XBehavioral Health & Social Service ProvidersCounselorSchool