Provider Demographics
NPI:1467921494
Name:BRASWELL, SARAH (LSW, CADC)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:BRASWELL
Suffix:
Gender:F
Credentials:LSW, CADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:236 POPPY HILLS DR
Mailing Address - Street 2:
Mailing Address - City:FERNLEY
Mailing Address - State:NV
Mailing Address - Zip Code:89408-7537
Mailing Address - Country:US
Mailing Address - Phone:775-544-8379
Mailing Address - Fax:
Practice Address - Street 1:991 S C ST
Practice Address - Street 2:
Practice Address - City:VIRGINIA CITY
Practice Address - State:NV
Practice Address - Zip Code:89440
Practice Address - Country:US
Practice Address - Phone:775-847-9311
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-11-20
Last Update Date:2018-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV8130-S104100000X
NV00297101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No104100000XBehavioral Health & Social Service ProvidersSocial Worker