Provider Demographics
NPI:1427925304
Name:BREAULT, SEAN PATRICK (LMSW)
Entity type:Individual
Prefix:MR
First Name:SEAN
Middle Name:PATRICK
Last Name:BREAULT
Suffix:
Gender:M
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:74 ROMBOUT AVE
Mailing Address - Street 2:
Mailing Address - City:BEACON
Mailing Address - State:NY
Mailing Address - Zip Code:12508-3209
Mailing Address - Country:US
Mailing Address - Phone:646-287-1603
Mailing Address - Fax:
Practice Address - Street 1:74 ROMBOUT AVE
Practice Address - Street 2:
Practice Address - City:BEACON
Practice Address - State:NY
Practice Address - Zip Code:12508-3209
Practice Address - Country:US
Practice Address - Phone:646-287-1603
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-10-23
Last Update Date:2025-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY129219104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Single Specialty