Stephany Rau Brackett, CISW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

866-122 Issued in WI

Practice address

3734 7TH Ave
Suite 12
Kenosha, WI 53140-5525

Phone

(262) 654-9370

Fax

(262) 654-9379

NPI assigned

Oct 25, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1161734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1871678581",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10011 136TH AVE",
            "city": "KENOSHA",
            "state": "WI",
            "postal_code": "531427946",
            "telephone_number": "262-857-9697"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3734 7TH AVE",
            "address_2": "SUITE 12",
            "city": "KENOSHA",
            "state": "WI",
            "postal_code": "531405525",
            "telephone_number": "262-654-9370",
            "fax_number": "262-654-9379"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRACKETT",
        "first_name": "STEPHANY",
        "middle_name": "RAU",
        "credential": "CISW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-25",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WI",
            "license": "866-122",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brian Daniel Boston, DMD
• Rommel Ortiz Bote', M.D.
• Ami Bouterse
• Robert Bruce Bower, OD
• Katie Lynn Bowers, ATC, LAT, CSCS
• Andrea J Brackman, P.A.
• Bradley N. Haugstad, M.D., S.C.
• Dara T Brady, RDH
• Jean Brady
• Brandi Berland R.D.H., LTD

• Clinical Social Worker in Kenosha, WI
• Providers in Kenosha, WI by specialty
• Clinical Social Worker in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.