Provider Demographics
NPI:1285678839
Name:BRAUN, SEAN (LPC)
Entity Type:Individual
Prefix:MR
First Name:SEAN
Middle Name:
Last Name:BRAUN
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 W ROSEDALE ST
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76104-4857
Mailing Address - Country:US
Mailing Address - Phone:817-338-4471
Mailing Address - Fax:
Practice Address - Street 1:301 W ROSEDALE ST
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76104-4857
Practice Address - Country:US
Practice Address - Phone:817-338-4471
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-15
Last Update Date:2013-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX17421101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1700791-02Medicaid
TX1700791-03Medicaid
TX170079101Medicaid