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NPI Code Detail

MEDICARE: JAMESHIA A BRAXTON LCSW

MEDICARE: JAMESHIA A BRAXTON LCSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social Worker2590-CAR

General Provider Information

NPI Number : 1487800082
Entity Type Code : Individual
Provider Name (Legal Business Name) : JAMESHIA A BRAXTON LCSW
Provider Business Mailing Address
First Line : 1405 N PIERCE ST
Second Line : STE 101
City : LITTLE ROCK
State : AR
Zip : 72207-5349
Country : US
Telephone Number : 501-603-2147
Fax Number : 501-603-0324
Provider Business Practice Location Address
First Line : 1405 N PIERCE ST
Second Line : STE 101
City : LITTLE ROCK
State : AR
Zip : 72207-5349
Country : US
Telephone Number : 501-603-2147
Fax Number : 501-603-0324
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/14/2008
Last Update Date : 12/18/2013

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Directions to “ JAMESHIA A BRAXTON LCSW” Practice Location

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