George Robert Braswell, M.A., LPA

Individual provider Active NPI Mental Health Counselor · Henrico, NC

NPI 1376747402 · NPPES record last updated Feb 10, 2010

Key facts

NPI
1376747402
Entity type
Individual (NPI type 1)
Primary specialty
Mental Health Counselor 101YM0800X
License
1402 (NC)
Practice address
421 Flat Rock Rd
Henrico, NC 27842-9419
Phone
(252) 532-5717
NPI assigned
Jun 13, 2007
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
1402NCMDMarriage & Family Therapist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 1402 NC Yes

Addresses

Primary practice location

421 Flat Rock Rd
Henrico, NC 27842-9419

Mailing address

421 Flat Rock Rd
Henrico, NC 27842-9419
Phone (252) 532-5717

Other providers in Henrico, NC

All providers in Henrico, NC · Mental Health Counselor in North Carolina

Sources for this page

Verify at the official NPI Registry.