Provider Demographics
NPI:1700346392
Name:BOND, BREANNA (MS, LPC)
Entity Type:Individual
Prefix:
First Name:BREANNA
Middle Name:
Last Name:BOND
Suffix:
Gender:F
Credentials:MS, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1329 E KEMPER RD STE 4220
Mailing Address - Street 2:
Mailing Address - City:SPRINGDALE
Mailing Address - State:OH
Mailing Address - Zip Code:45246-5100
Mailing Address - Country:US
Mailing Address - Phone:513-580-8747
Mailing Address - Fax:
Practice Address - Street 1:1329 E KEMPER RD STE 4220
Practice Address - Street 2:
Practice Address - City:SPRINGDALE
Practice Address - State:OH
Practice Address - Zip Code:45246-5100
Practice Address - Country:US
Practice Address - Phone:513-580-8747
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-21
Last Update Date:2022-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHC.2103151101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health