Provider Demographics
NPI:1093582611
Name:BREEN, ERIN
Entity Type:Individual
Prefix:
First Name:ERIN
Middle Name:
Last Name:BREEN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:411 FLEMINGTON RD APT 249
Mailing Address - Street 2:
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27517-5679
Mailing Address - Country:US
Mailing Address - Phone:215-429-6031
Mailing Address - Fax:
Practice Address - Street 1:2740 NC 55 HWY # 210
Practice Address - Street 2:
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27519-6209
Practice Address - Country:US
Practice Address - Phone:215-429-6031
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-12-04
Last Update Date:2023-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP0194311041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical