Provider Demographics
NPI:1154738896
Name:ANTONAS, BRIANNE (MSW, LISW, CDCA)
Entity type:Individual
Prefix:MRS
First Name:BRIANNE
Middle Name:
Last Name:ANTONAS
Suffix:
Gender:F
Credentials:MSW, LISW, CDCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6942 TYLERSVILLE RD
Mailing Address - Street 2:
Mailing Address - City:WEST CHESTER
Mailing Address - State:OH
Mailing Address - Zip Code:45069-1511
Mailing Address - Country:US
Mailing Address - Phone:513-868-0055
Mailing Address - Fax:
Practice Address - Street 1:6942 TYLERSVILLE RD
Practice Address - Street 2:
Practice Address - City:WEST CHESTER
Practice Address - State:OH
Practice Address - Zip Code:45069-1511
Practice Address - Country:US
Practice Address - Phone:513-868-0055
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-15
Last Update Date:2016-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI.16002621041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical