MEDICARE: MRS. DANA C BRANSON LCSW, CASAC

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
1	1041C0700X	Clinical Social Worker	005663	MO

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier Issuer
1	2111503	OTHER	FIRST HEALTH/COVENTRY
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	431116734	OTHER	UNITED BEHAVIORAL HEALTH
4	431116734	OTHER	EAP CERIDIAN
5	43111673463857A	OTHER	TRI CARE WEST
6	162909	OTHER	BLUE CROSS BLUE SHIELD
7	431116734	OTHER	EAP CONCERN
8	431116734	OTHER	NEW DIRECTIONS
9	51130	OTHER	MOUNT CARMEL
10	11333199	OTHER	CAQH
11	431116734	OTHER	EAP NEW DIRECTIONS
12	431116734	OTHER	EAP WELLPOINT
13	431116734	OTHER	EAP INTERFACE
14	713386	OTHER	HEALTHLINK PPO

General Provider Information

NPI Number	:	1568468627
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. DANA C BRANSON LCSW, CASAC

Provider Business Mailing Address
First Line	:	20 S SPRIGG ST
Second Line	:
City	:	CAPE GIRARDEAU
State	:	MO
Zip	:	63703-6212
Country	:	US
Telephone Number	:	573-651-4177
Fax Number	:	573-651-3636

Provider Business Practice Location Address
First Line	:	20 S SPRIGG ST
Second Line	:
City	:	CAPE GIRARDEAU
State	:	MO
Zip	:	63703-6212
Country	:	US
Telephone Number	:	573-651-4177
Fax Number	:	573-651-3636

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/23/2005
Last Update Date	:	07/11/2008

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