Provider Demographics
NPI:1366864506
Name:SIMANTON, BREANNA SUE (LMHC)
Entity Type:Individual
Prefix:DR
First Name:BREANNA
Middle Name:SUE
Last Name:SIMANTON
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 E ROBINSON ST STE 425
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32801-4347
Mailing Address - Country:US
Mailing Address - Phone:407-647-1781
Mailing Address - Fax:407-647-4628
Practice Address - Street 1:200 E ROBINSON ST STE 425
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32801-4347
Practice Address - Country:US
Practice Address - Phone:407-647-1781
Practice Address - Fax:407-647-4628
Is Sole Proprietor?:No
Enumeration Date:2014-01-07
Last Update Date:2023-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH12240101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health