Healthcare Provider Details

I. General information

NPI: 1356861793
Provider Name (Legal Business Name): JENNIFER L BRAMLETT LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/27/2017
Last Update Date: 05/20/2025
Certification Date: 05/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9702 STONESTREET RD STE 310
LOUISVILLE KY
40272-6820
US

IV. Provider business mailing address

9702 STONESTREET RD STE 310
LOUISVILLE KY
40272-6820
US

V. Phone/Fax

Practice location:
  • Phone: 855-591-0092
  • Fax:
Mailing address:
  • Phone: 855-591-0092
  • Fax: 502-631-9660

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number013948
License Number StateCT
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number252364
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: