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General NPI Number Information
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NPI Number | 1518569946
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Entity Type | Individual
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Provider Name | KENNA RAE BRAUCHLER MSW, LSW
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Gender | Female
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Dates
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Enumeration Date | 11/11/2020
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Last Update Date | 09/15/2023
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Provider Practice Location Address
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Address Line | 7112 W JEFFERSON AVE # 207
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City | LAKEWOOD
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State | CO
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Zip | 80235-2308
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Country | US
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Telephone | 720-445-6274
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Fax |
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Provider Business Mailing Address
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Address Line | 6442 S HOLLAND CT
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City | LITTLETON
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State | CO
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Zip | 80123-3167
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Country | US
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Telephone | 308-258-0847
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | LSW.0009922799
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License Number State | CO
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