1700409869 NPI number — BREANNE HALL STANERT M.ED., LMHC, LPC

NPI Number: 1700409869
Health Care Provider/Practitioner: BREANNE HALL STANERT M.ED., LMHC, LPC

NPI Number : 1700409869 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1700409869",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "STANERT",
    "FirstName": "BREANNE",
    "MiddleName": "HALL",
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "M.ED., LMHC, LPC",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "HALL",
    "OtherFirstName": "BREANNE",
    "OtherMiddleName": "LEAH",
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": "1",
    "FirstLineMailingAddress": "2054 CREEKMONT DR",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "MIDDLEBURG",
    "MailingAddressStateName": "FL",
    "MailingAddressPostalCode": "32068-6874",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "912-687-1661",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "1845 TOWN CENTER BLVD",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "FLEMING ISLAND",
    "PracticeLocationAddressStateName": "FL",
    "PracticeLocationAddressPostalCode": "32003-3356",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "904-649-5175",
    "PracticeLocationAddressFaxNumber": "904-452-7854",
    "EnumerationDate": "05/24/2020",
    "LastUpdateDate": "07/10/2025",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "F",
    "Gender": "Female",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "101Y00000X",
          "TaxonomyName": "Counselor",
          "LicenseNumber": "007887",
          "LicenseNumberStateCode": "GA",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "101Y00000X",
          "TaxonomyName": "Counselor",
          "LicenseNumber": "17550",
          "LicenseNumberStateCode": "FL",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "101YM0800X",
          "TaxonomyName": "Mental Health Counselor",
          "LicenseNumber": "17550",
          "LicenseNumberStateCode": "FL",
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}