Provider Demographics
NPI:1447799895
Name:BRAMEL, SUSAN (LPCA)
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:
Last Name:BRAMEL
Suffix:
Gender:F
Credentials:LPCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2099 KY HIGHWAY 982
Mailing Address - Street 2:
Mailing Address - City:CYNTHIANA
Mailing Address - State:KY
Mailing Address - Zip Code:41031-9629
Mailing Address - Country:US
Mailing Address - Phone:859-221-3537
Mailing Address - Fax:
Practice Address - Street 1:209 E PIKE ST
Practice Address - Street 2:
Practice Address - City:CYNTHIANA
Practice Address - State:KY
Practice Address - Zip Code:41031-1681
Practice Address - Country:US
Practice Address - Phone:859-569-3145
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-02-17
Last Update Date:2017-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY1242101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health