Provider Demographics
NPI:1255856316
Name:BRAUN, HEATHER MARIE (LCSW)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:MARIE
Last Name:BRAUN
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 1:6012 REEF POINT LN STE C
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76135-2056
Mailing Address - Country:US
Mailing Address - Phone:682-312-8184
Mailing Address - Fax:817-238-1232
Practice Address - Street 1:6012 REEF POINT LN STE C
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76135-2056
Practice Address - Country:US
Practice Address - Phone:682-312-8184
Practice Address - Fax:817-238-1232
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-10
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX584781041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical