Provider Demographics
NPI:1083950265
Name:BRECKENRIDGE, BARBARA A (LISW-S)
Entity Type:Individual
Prefix:MRS
First Name:BARBARA
Middle Name:A
Last Name:BRECKENRIDGE
Suffix:
Gender:F
Credentials:LISW-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7140 OFFICE PARK DR
Mailing Address - Street 2:
Mailing Address - City:WEST CHESTER
Mailing Address - State:OH
Mailing Address - Zip Code:45069-2261
Mailing Address - Country:US
Mailing Address - Phone:513-777-2428
Mailing Address - Fax:513-777-0017
Practice Address - Street 1:7140 OFFICE PARK DR
Practice Address - Street 2:
Practice Address - City:WEST CHESTER
Practice Address - State:OH
Practice Address - Zip Code:45069-2261
Practice Address - Country:US
Practice Address - Phone:513-777-2428
Practice Address - Fax:513-777-0017
Is Sole Proprietor?:No
Enumeration Date:2012-12-17
Last Update Date:2012-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI-0000102-S1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical