Individual
DR. LEWIS S. BREITNER
Active
Individual
DR. LEWIS S. BREITNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
559
MA
103TC0700X
Clinical Psychologist
Primary
2143
MA
106H00000X
Marriage & Family Therapist
245
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03000050
—
MA
01
—
10805
PSYCHOLOGIST
MA
01
—
BRW50574
PTAN
MA
Enumeration date
11/23/2005
Last updated
04/18/2016
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