Healthcare Provider Details

I. General information

NPI: 1982965117
Provider Name (Legal Business Name): BREANNE CHRISTIAN MSW, LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/05/2012
Last Update Date: 09/24/2025
Certification Date: 09/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

102 PICKERING WAY STE 506
EXTON PA
19341-1330
US

IV. Provider business mailing address

102 PICKERING WAY STE 506
EXTON PA
19341-1330
US

V. Phone/Fax

Practice location:
  • Phone: 856-472-5092
  • Fax:
Mailing address:
  • Phone: 856-472-5092
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberCW022638
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number44SC05531700
License Number StateNJ

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: