Provider Demographics
NPI:1467429506
Name:BRASWELL, GRACE MARIE (LPC)
Entity Type:Individual
Prefix:MRS
First Name:GRACE
Middle Name:MARIE
Last Name:BRASWELL
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:360 BEECH STREET
Mailing Address - Street 2:PO BOX 40
Mailing Address - City:NEWLAND
Mailing Address - State:NC
Mailing Address - Zip Code:28657-0040
Mailing Address - Country:US
Mailing Address - Phone:828-733-5889
Mailing Address - Fax:828-262-5687
Practice Address - Street 1:360 BEECH STREET
Practice Address - Street 2:
Practice Address - City:NEWLAND
Practice Address - State:NC
Practice Address - Zip Code:28657-0040
Practice Address - Country:US
Practice Address - Phone:828-733-5889
Practice Address - Fax:828-262-5687
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-08
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC4822101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC2234498OtherCIGNA BEHAVIORAL HEALTH
NCN/AOtherMHNET
NC6102750Medicaid
NC1393KOtherBCBS OF NC
NCE1764OtherMEDCOST
NCN/AOtherCBHA