Provider Demographics
NPI:1336511377
Name:BRAKE, DANIEL (LMFT-S)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:
Last Name:BRAKE
Suffix:
Gender:M
Credentials:LMFT-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2028E. BEN WHITE BLVD
Mailing Address - Street 2:STE 240 PMB 3499
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78741-6931
Mailing Address - Country:US
Mailing Address - Phone:512-665-3499
Mailing Address - Fax:
Practice Address - Street 1:5008 RANCH ACRES DR
Practice Address - Street 2:
Practice Address - City:LOVELAND
Practice Address - State:CO
Practice Address - Zip Code:80538-1638
Practice Address - Country:US
Practice Address - Phone:512-665-3499
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-29
Last Update Date:2024-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX201994106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist