Provider Demographics
NPI:1982965117
Name:BURNLEY, BREANNE (MSW, LCSW)
Entity Type:Individual
Prefix:MISS
First Name:BREANNE
Middle Name:
Last Name:BURNLEY
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1266 OLLERTON RD
Mailing Address - Street 2:
Mailing Address - City:WEST DEPTFORD
Mailing Address - State:NJ
Mailing Address - Zip Code:08066-1918
Mailing Address - Country:US
Mailing Address - Phone:856-264-0255
Mailing Address - Fax:
Practice Address - Street 1:708 ROUTE 50
Practice Address - Street 2:SUITE B (SECOND FLOOR)
Practice Address - City:MAYS LANDING
Practice Address - State:NJ
Practice Address - Zip Code:08330-2122
Practice Address - Country:US
Practice Address - Phone:856-264-0255
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-05
Last Update Date:2021-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC055317001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical