Healthcare Provider Details

I. General information

NPI: 1568309243
Provider Name (Legal Business Name): BREANA RAMUS LISW-S
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/30/2026
Last Update Date: 04/30/2026
Certification Date: 04/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4375 CHELSEA DR
BELLBROOK OH
45305-2312
US

IV. Provider business mailing address

4375 CHELSEA DR
BELLBROOK OH
45305-2312
US

V. Phone/Fax

Practice location:
  • Phone: 937-949-1603
  • Fax:
Mailing address:
  • Phone: 937-949-1603
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberI.2506332-SUPV
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: