Susan J Braun, LCSW
Individual provider Active NPI Mental Health Counselor · Derby, CT
NPI 1154484053 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1154484053
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Mental Health Counselor 101YM0800X
- License
- 04856 (CT)
- Practice address
- 130 Division St
Derby, CT 06418-1326 - Phone
- (203) 732-7550
- NPI assigned
- Dec 19, 2006
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 04856 | CT | MD | Mental Health Counselor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 04856 | CT | Yes |
Addresses
Primary practice location
130 Division St
Derby, CT 06418-1326
Mailing address
130 Division St
Derby, CT 06418-1326
Phone (203) 732-7550
Other providers in Derby, CT
- Jessica Borges
- Gregory Boris
- Kimberly Aine Bottone
- Katherine L. Boxberger
- Brielle Braun
- Jacqueline Braunworth
- Virginia Breeden
- Frederick A Browne
- Jacquelyn L Browne
- Katherine N Bunger
All providers in Derby, CT · Mental Health Counselor in Connecticut
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. 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.