Healthcare Provider Details

I. General information

NPI: 1114896487
Provider Name (Legal Business Name): BRIANNE HUFFINGTON LSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: BRIANNE NERO LSW

II. Dates (important events)

Enumeration Date: 11/04/2025
Last Update Date: 11/04/2025
Certification Date: 11/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

777 S MAIN ST STE 100
CLINTON IN
47842-2493
US

IV. Provider business mailing address

1929 E LEXINGTON DR
TERRE HAUTE IN
47802-5043
US

V. Phone/Fax

Practice location:
  • Phone: 765-828-1003
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number33013202A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: