Provider Demographics
NPI:1639533136
Name:BRILEY, BRE' JON S
Entity Type:Individual
Prefix:MISS
First Name:BRE' JON
Middle Name:S
Last Name:BRILEY
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 1:3100 RIDGELAKE DR STE 309
Mailing Address - Street 2:
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70002-4938
Mailing Address - Country:US
Mailing Address - Phone:504-309-0259
Mailing Address - Fax:504-309-2702
Practice Address - Street 1:3100 RIDGELAKE DR STE 309
Practice Address - Street 2:
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70002-4938
Practice Address - Country:US
Practice Address - Phone:504-309-0259
Practice Address - Fax:504-309-2702
Is Sole Proprietor?:No
Enumeration Date:2016-04-11
Last Update Date:2023-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No101Y00000XBehavioral Health & Social Service ProvidersCounselor