Provider Demographics
NPI:1790353134
Name:HENNING, BRIANNA (MSW)
Entity Type:Individual
Prefix:
First Name:BRIANNA
Middle Name:
Last Name:HENNING
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9185 W 107TH PL
Mailing Address - Street 2:
Mailing Address - City:SAINT JOHN
Mailing Address - State:IN
Mailing Address - Zip Code:46373-8512
Mailing Address - Country:US
Mailing Address - Phone:219-616-6633
Mailing Address - Fax:
Practice Address - Street 1:521 E 86TH AVE STE H
Practice Address - Street 2:
Practice Address - City:MERRILLVILLE
Practice Address - State:IN
Practice Address - Zip Code:46410-6236
Practice Address - Country:US
Practice Address - Phone:219-323-3311
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-13
Last Update Date:2021-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker