Provider Demographics
NPI:1649749912
Name:BREUNINGER, MATTHEW (PSYD)
Entity Type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:
Last Name:BREUNINGER
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1124 OREGON AVE
Mailing Address - Street 2:
Mailing Address - City:STEUBENVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43952-1652
Mailing Address - Country:US
Mailing Address - Phone:570-575-8394
Mailing Address - Fax:
Practice Address - Street 1:415 N 4TH ST
Practice Address - Street 2:
Practice Address - City:STEUBENVILLE
Practice Address - State:OH
Practice Address - Zip Code:43952-2021
Practice Address - Country:US
Practice Address - Phone:740-278-7755
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-11-16
Last Update Date:2018-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHP.07786103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical