Provider Demographics
NPI:1265797393
Name:BREINER, JOY ELANA (MA)
Entity type:Individual
Prefix:
First Name:JOY
Middle Name:ELANA
Last Name:BREINER
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:ELANA
Other - Middle Name:
Other - Last Name:BREINER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LMFT
Mailing Address - Street 1:5445 VILLAGE DR STE 102
Mailing Address - Street 2:
Mailing Address - City:VIERA
Mailing Address - State:FL
Mailing Address - Zip Code:32955-6666
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5445 VILLAGE DR STE 102
Practice Address - Street 2:
Practice Address - City:VIERA
Practice Address - State:FL
Practice Address - Zip Code:32955-6666
Practice Address - Country:US
Practice Address - Phone:321-204-2048
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-04
Last Update Date:2024-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMT3205106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist