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NPI Code Detail

MEDICARE: ELIZABETH BRANT LPC-CR, ATR

MEDICARE: ELIZABETH BRANT LPC-CR, ATR
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
1101YM0800XMental Health CounselorC1200374OH

General Provider Information

NPI Number : 1912368713
Entity Type Code : Individual
Provider Name (Legal Business Name) : ELIZABETH BRANT LPC-CR, ATR
Provider Business Mailing Address
First Line : 2379 HUBBARD RD
Second Line :
City : MADISON
State : OH
Zip : 44057-2523
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 12041 RAVENNA RD
Second Line :
City : CHARDON
State : OH
Zip : 44024-7008
Country : US
Telephone Number : 440-286-7154
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/08/2016
Last Update Date : 03/08/2016

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