Provider Demographics
NPI:1013200476
Name:BRANT, BECKY SUE (LMSW)
Entity Type:Individual
Prefix:MISS
First Name:BECKY
Middle Name:SUE
Last Name:BRANT
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:33300 WARREN RD STE 19
Mailing Address - Street 2:
Mailing Address - City:WESTLAND
Mailing Address - State:MI
Mailing Address - Zip Code:48185-9627
Mailing Address - Country:US
Mailing Address - Phone:734-799-7351
Mailing Address - Fax:734-661-6786
Practice Address - Street 1:33300 WARREN RD STE 19
Practice Address - Street 2:
Practice Address - City:WESTLAND
Practice Address - State:MI
Practice Address - Zip Code:48185-9627
Practice Address - Country:US
Practice Address - Phone:734-799-7646
Practice Address - Fax:734-661-6786
Is Sole Proprietor?:No
Enumeration Date:2011-05-18
Last Update Date:2023-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010924321041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical