Provider Demographics
NPI:1114351905
Name:BRAMAN, JENNIFER L (LMSW)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:L
Last Name:BRAMAN
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 1:5169 E MANITOU WAY
Mailing Address - Street 2:
Mailing Address - City:NEWAYGO
Mailing Address - State:MI
Mailing Address - Zip Code:49337-8710
Mailing Address - Country:US
Mailing Address - Phone:231-245-6693
Mailing Address - Fax:
Practice Address - Street 1:130 W WOOD ST
Practice Address - Street 2:
Practice Address - City:NEWAYGO
Practice Address - State:MI
Practice Address - Zip Code:49337-8991
Practice Address - Country:US
Practice Address - Phone:231-206-6159
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-08-28
Last Update Date:2023-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68011049621041C0700X
MI6802085334104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker