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General NPI Number Information
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NPI Number | 1578966883
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Entity Type | Organization
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Legal Business Name | THE BRAMBLE NETWORK
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Dates
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Enumeration Date | 09/30/2014
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Last Update Date | 09/30/2014
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Provider Practice Location Address
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Address Line | 501 N FREDERICK AVE SUITE 300
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City | GAITHERSBURG
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State | MD
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Zip | 20877-2507
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Country | US
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Telephone | 301-651-4594
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Fax | 301-830-4594
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Provider Business Mailing Address
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Address Line | 501 N FREDERICK AVE SUITE 300
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City | GAITHERSBURG
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State | MD
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Zip | 20877-2507
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Country | US
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Telephone | 301-651-4594
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Fax | 301-830-4594
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Authorized Official
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Title or Position | CEO
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Name | MS. SIMONE BRAMBLE
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Credential | LCSW-C
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Telephone | 301-651-4594
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | LCA388
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number | LC1990
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License Number State | MD
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Taxonomy #3
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | LC1990
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License Number State | MD
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Taxonomy #4
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | LC1990
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License Number State | MD
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Taxonomy #5
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number | 14931
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License Number State | MD
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Taxonomy #6
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Taxonomy Code | 103TC2200X
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Taxonomy Name | Clinical Child & Adolescent Psychologist
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License Number | 14931
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License Number State | MD
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Taxonomy #7
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Taxonomy Code | 103TP2701X
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Taxonomy Name | Group Psychotherapy Psychologist
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License Number | 14931
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License Number State | MD
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Taxonomy #8
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | 14931
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License Number State | MD
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Taxonomy #9
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 14931
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License Number State | MD
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Taxonomy #10
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 14931
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License Number State | MD
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