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General NPI Number Information
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NPI Number | 1568324804
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Entity Type | Organization
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Legal Business Name | RANDY BRAFF, LCSW, PC
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Dates
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Enumeration Date | 11/25/2025
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Last Update Date | 11/25/2025
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Provider Practice Location Address
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Address Line | 2079 WANTAGH AVE STE 1C
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City | WANTAGH
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State | NY
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Zip | 11793-3924
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Country | US
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Telephone | 631-827-8387
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Fax |
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Provider Business Mailing Address
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Address Line | 182 PHYLLIS DR
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City | PATCHOGUE
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State | NY
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Zip | 11772-2958
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Country | US
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Telephone | 631-827-8387
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MR. RANDY LEE BRAFF
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Credential | LCSW-R
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Telephone | 631-827-8387
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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