Kimberly Mi-Suk Brauda, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

LPC004820 Issued in GA

Practice address

Statesboro Psychiatric Associates
116 Hill Pond Lane
Statesboro, GA 30458

Phone

(912) 489-1629

Fax

(912) 489-1630

NPI assigned

Aug 7, 2013

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Statesboro Psychiatric Associates

  • Psychiatry Physician
  • Statesboro, GA
  • NPI 1083830400
  NPD (past)

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

{
    "created_epoch": "1375833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1576108800000",
    "number": "1700218179",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "STATESBORO PSYCHIATRIC ASSOCIATES",
            "address_2": "116 HILL POND LANE",
            "city": "STATESBORO",
            "state": "GA",
            "postal_code": "30458",
            "telephone_number": "912-489-1629",
            "fax_number": "912-489-1630"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "STATESBORO PSYCHIATRIC ASSOCIATES",
            "address_2": "116 HILL POND LANE",
            "city": "STATESBORO",
            "state": "GA",
            "postal_code": "30458",
            "telephone_number": "912-489-1629",
            "fax_number": "912-489-1630"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRAUDA",
        "first_name": "KIMBERLY",
        "middle_name": "MI-SUK",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-08-07",
        "last_updated": "2019-12-12",
        "certification_date": "2019-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "GA",
            "license": "004820",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "GA",
            "license": "LPC004820",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mary Virginia Brady
• Allison Bragg, RN
• Carla S. Branch, M.D.
• Morgan Brannen
• Taraya Nicole Bratton
• Brave Tomorrow Counseling and Consulting
• Cecil Baxter Bray III, DMD
• Charity Ruth Bray
• Bray, DMD & Young, DMD, PC
• Karen E Brazell, APRN

• Professional Counselor in Statesboro, GA
• Providers in Statesboro, GA by specialty
• Professional Counselor in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2019; 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.