Provider Demographics
NPI:1083940142
Name:BRAUNINGER, CARRIE ANN (LCSW)
Entity Type:Individual
Prefix:
First Name:CARRIE
Middle Name:ANN
Last Name:BRAUNINGER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:340 E 1ST AVE STE 101
Mailing Address - Street 2:
Mailing Address - City:BROOMFIELD
Mailing Address - State:CO
Mailing Address - Zip Code:80020-2444
Mailing Address - Country:US
Mailing Address - Phone:303-544-3800
Mailing Address - Fax:303-544-3818
Practice Address - Street 1:340 E 1ST AVE STE 101
Practice Address - Street 2:
Practice Address - City:BROOMFIELD
Practice Address - State:CO
Practice Address - Zip Code:80020-2444
Practice Address - Country:US
Practice Address - Phone:303-544-3800
Practice Address - Fax:303-544-3818
Is Sole Proprietor?:No
Enumeration Date:2009-10-26
Last Update Date:2020-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY56291041C0700X
COCSW.099230651041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY610661458OtherGROUP TAX ID NUMBER