Provider Demographics
NPI:1629487509
Name:BREINER, JOANN (LPC-MHSP)
Entity Type:Individual
Prefix:
First Name:JOANN
Middle Name:
Last Name:BREINER
Suffix:
Gender:F
Credentials:LPC-MHSP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:805 S CHURCH ST STE 17
Mailing Address - Street 2:
Mailing Address - City:MURFREESBORO
Mailing Address - State:TN
Mailing Address - Zip Code:37130-4917
Mailing Address - Country:US
Mailing Address - Phone:615-900-4357
Mailing Address - Fax:
Practice Address - Street 1:805 S CHURCH ST STE 17
Practice Address - Street 2:
Practice Address - City:MURFREESBORO
Practice Address - State:TN
Practice Address - Zip Code:37130-4917
Practice Address - Country:US
Practice Address - Phone:615-900-4357
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-05
Last Update Date:2019-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH12670101YP2500X
TN3972101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional