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General NPI Number Information
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NPI Number | 1336923408
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Entity Type | Individual
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Provider Name | JENNIFER BRAAM LCPC, LMHC
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Gender | Female
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Dates
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Enumeration Date | 08/21/2023
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Last Update Date | 08/21/2023
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Provider Practice Location Address
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Address Line | 6262 142ND AVE N UNIT 901
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City | CLEARWATER
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State | FL
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Zip | 33760-2771
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Country | US
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Telephone | 708-288-1916
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Fax |
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Provider Business Mailing Address
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Address Line | 6262 142ND AVE N UNIT 901
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City | CLEARWATER
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State | FL
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Zip | 33760-2771
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Country | US
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Telephone | 708-288-1916
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 180.009969
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | MH20563
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License Number State | FL
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