Active NPI
Debera Bragg, LMFT
- Counselor
- Shelbyville, IN
National Provider Identifier
1205074291
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- License
- 35001652A
- Practice address
- 1620 S Miller St
Shelbyville, IN 46176-2951 - Phone
- (317) 642-7194
- NPI assigned
- Jan 28, 2009
- Last updated
- Sep 16, 2011
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | 35001652A | IN | Primary |
Addresses
Primary practice location
1620 S Miller St
Shelbyville, IN 46176-2951
Mailing address
1620 S Miller St
Shelbyville, IN 46176-2951
Phone (317) 642-7194
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 35001652A | IN | MD | Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1233100800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1316131200000",
"number": "1205074291",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1620 S MILLER ST",
"city": "SHELBYVILLE",
"state": "IN",
"postal_code": "461762951",
"telephone_number": "317-642-7194"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1620 S MILLER ST",
"city": "SHELBYVILLE",
"state": "IN",
"postal_code": "461762951",
"telephone_number": "317-642-7194"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRAGG",
"first_name": "DEBERA",
"credential": "LMFT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2009-01-28",
"last_updated": "2011-09-16",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "IN",
"license": "35001652A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Shelbyville, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.