John Alfred Breyer, BA,QMHS
Individual provider Active NPI Social Worker · Moraine, OH
NPI 1215424767 · NPPES record last updated Dec 19, 2022
Key facts
- NPI
- 1215424767
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Social Worker 104100000X
- License
- S.2202353-TRNE (OH)
- Practice address
- 3095 Kettering Blvd
Moraine, OH 45439-1983 - Phone
- (937) 293-8300
- NPI assigned
- Apr 20, 2018
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Bachelor of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| S.2202353-TRNE | OH | MD | Social Worker |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | S.2202353-TRNE | OH | Yes |
Addresses
Primary practice location
3095 Kettering Blvd
Moraine, OH 45439-1983
Mailing address
3095 Kettering Blvd
Moraine, OH 45439-1983
Phone (937) 293-8300
Other providers in Moraine, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 19, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.