Provider Demographics
NPI:1184820235
Name:STROM-BRAUGHTON, ELIZABETH SUE (LMHC)
Entity Type:Individual
Prefix:MS
First Name:ELIZABETH
Middle Name:SUE
Last Name:STROM-BRAUGHTON
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:ELIZABETH
Other - Middle Name:SUE
Other - Last Name:BRAUGHTON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LMHC
Mailing Address - Street 1:1111 HELMSDALE DR.
Mailing Address - Street 2:
Mailing Address - City:WESLEY CHAPEL
Mailing Address - State:FL
Mailing Address - Zip Code:33543-3914
Mailing Address - Country:US
Mailing Address - Phone:813-765-6249
Mailing Address - Fax:813-948-0788
Practice Address - Street 1:24160 STATE RD 54
Practice Address - Street 2:SUITE 5
Practice Address - City:LUTZ
Practice Address - State:FL
Practice Address - Zip Code:33559-6766
Practice Address - Country:US
Practice Address - Phone:813-765-6249
Practice Address - Fax:813-948-0788
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-25
Last Update Date:2012-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH3182101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health