Elizabeth Duggan Bralley

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

LGP10373 Issued in MD

Practice address

5652 Shields Dr
Bethesda, MD 20817-3574

Phone

(240) 225-0522

NPI assigned

Aug 16, 2020

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1597536000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597536000000",
    "number": "1427669076",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11713 N SHORE DR",
            "city": "RESTON",
            "state": "VA",
            "postal_code": "201904505",
            "telephone_number": "703-740-7699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5652 SHIELDS DR",
            "city": "BETHESDA",
            "state": "MD",
            "postal_code": "208173574",
            "telephone_number": "240-225-0522"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRALLEY",
        "first_name": "ELIZABETH",
        "middle_name": "DUGGAN",
        "name_prefix": "Ms.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-08-16",
        "last_updated": "2020-08-16",
        "certification_date": "2020-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": "MD",
            "license": "LGP10373",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAREFIRST BLUE CROSS BLUE SHIELD",
            "identifier": "1386161305",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Mental Health Counselor in Bethesda, MD
• Providers in Bethesda, MD by specialty
• Mental Health Counselor in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.