Provider Demographics
NPI:1700378957
Name:BRECKNER, LILLIAN SUSAN (MA)
Entity type:Individual
Prefix:MS
First Name:LILLIAN
Middle Name:SUSAN
Last Name:BRECKNER
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:171 DEER TRAIL RD
Mailing Address - Street 2:
Mailing Address - City:DURANGO
Mailing Address - State:CO
Mailing Address - Zip Code:81303-7618
Mailing Address - Country:US
Mailing Address - Phone:612-889-2558
Mailing Address - Fax:
Practice Address - Street 1:777 MAIN AVE STE 206
Practice Address - Street 2:
Practice Address - City:DURANGO
Practice Address - State:CO
Practice Address - Zip Code:81301-5424
Practice Address - Country:US
Practice Address - Phone:970-335-9186
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-04
Last Update Date:2025-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist