Loretta Elaine Braxton, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

1679 Issued in NC

Practice address

3706 Sunningdale Way
Durham, NC 27707-5684

Phone

(919) 423-4324

Fax

(919) 489-6365

NPI assigned

Nov 30, 2005

Last updated

Jul 9, 2025By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1133308800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752019200000",
    "number": "1689658072",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3706 SUNNINGDALE WAY",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277075684",
            "telephone_number": "919-423-4324",
            "fax_number": "919-489-6365"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3706 SUNNINGDALE WAY",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277075684",
            "telephone_number": "919-423-4324",
            "fax_number": "919-489-6365"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRAXTON",
        "first_name": "LORETTA",
        "middle_name": "ELAINE",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-11-30",
        "last_updated": "2025-07-09",
        "certification_date": "2025-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NC",
            "license": "1679",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NC",
            "license": "1679",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6000707",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• John Brazzle

• Clinical Psychologist in Durham, NC
• Providers in Durham, NC by specialty
• Clinical Psychologist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2025; 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.