Susan Diane Branam, LADC, LCSW
Individual provider Active NPI Clinical Social Worker · Blanchard, OK
NPI 1376775775 · NPPES record last updated Oct 24, 2012
Key facts
- NPI
- 1376775775
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- 2913 (OK)
- Practice address
- 2320 County Road 1254
Blanchard, OK 73010-3019 - Phone
- (918) 302-7080
- Fax
- (405) 392-2936
- NPI assigned
- Aug 18, 2009
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|
| 2913 | OK | MD | Professional Counselor |
| 2913 | TX | MD | Nutrition Support Pharmacist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 594 | OK | |
| Mental Health Counselor | 101YM0800X | 2913 | OK | |
| Clinical Social Worker | 1041C0700X | 2913 | OK | Yes |
| Marriage & Family Therapist | 106H00000X | 2913 | OK |
Addresses
Primary practice location
2320 County Road 1254
Blanchard, OK 73010-3019
Mailing address
2320 County Road 1254
Blanchard, OK 73010-3019
Phone (918) 302-7080
Other providers in Blanchard, OK
- Blanchard Family Medicine
- Blanchard Molar
- Bloomquist Foot and Ankle PLLC
- Misty Marie Bogle
- Shawn Patrick Bonilla
- Brant D. Spencer D.C. P.C.
- Cassie Jo Brown
- Tyler Adam Brown
- Brooklyne N. Brumley
- Leslie Diane Butler
All providers in Blanchard, OK · Clinical Social Worker in Oklahoma
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 24, 2012. 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.