Provider Demographics
NPI:1700635174
Name:EALY, BRIAUNA NAONA (LMSW)
Entity type:Individual
Prefix:
First Name:BRIAUNA
Middle Name:NAONA
Last Name:EALY
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1269 PARKWAY PL APT E
Mailing Address - Street 2:
Mailing Address - City:CLARKSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37042-8436
Mailing Address - Country:US
Mailing Address - Phone:931-249-3384
Mailing Address - Fax:
Practice Address - Street 1:101 HATCHER LN STE D
Practice Address - Street 2:
Practice Address - City:CLARKSVILLE
Practice Address - State:TN
Practice Address - Zip Code:37043-6496
Practice Address - Country:US
Practice Address - Phone:931-266-0830
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-16
Last Update Date:2024-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN14302104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker