Provider Demographics
NPI:1407257462
Name:BRATT, BRYON KENNETH (LIMHP, LMHP, PC)
Entity Type:Individual
Prefix:MR
First Name:BRYON
Middle Name:KENNETH
Last Name:BRATT
Suffix:
Gender:M
Credentials:LIMHP, LMHP, PC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:810 E 9TH ST
Mailing Address - Street 2:
Mailing Address - City:HICKMAN
Mailing Address - State:NE
Mailing Address - Zip Code:68372-9505
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:620 N 48TH ST
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68504-3467
Practice Address - Country:US
Practice Address - Phone:402-489-6196
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-09
Last Update Date:2014-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1276101YM0800X
NE2046101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional