Provider Demographics
NPI:1396816955
Name:BRAMLETTE, SUSAN JOY (LMFT)
Entity Type:Individual
Prefix:MS
First Name:SUSAN
Middle Name:JOY
Last Name:BRAMLETTE
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2250 NW FLANDERS ST
Mailing Address - Street 2:STE. 310
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97210-3443
Mailing Address - Country:US
Mailing Address - Phone:503-956-5144
Mailing Address - Fax:360-885-4944
Practice Address - Street 1:2250 NW FLANDERS ST
Practice Address - Street 2:STE. 310
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97210-3443
Practice Address - Country:US
Practice Address - Phone:503-956-5144
Practice Address - Fax:360-885-4944
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORT0456101YP2500X
AZLMFT10129101YP2500X
IDLMFT 2909101YP2500X
WALF00001909101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional