Provider Demographics
NPI:1477687473
Name:BRAZNER, JANET ARLENE (LCSW)
Entity Type:Individual
Prefix:MS
First Name:JANET
Middle Name:ARLENE
Last Name:BRAZNER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:124 W 93RD ST
Mailing Address - Street 2:2E
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10025-7536
Mailing Address - Country:US
Mailing Address - Phone:212-866-4943
Mailing Address - Fax:212-866-4943
Practice Address - Street 1:124 W 93RD ST
Practice Address - Street 2:2E
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10025-7536
Practice Address - Country:US
Practice Address - Phone:212-866-4943
Practice Address - Fax:212-866-4943
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYLCSW0125041041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYNO3181Medicare ID - Type Unspecified