Provider Demographics
NPI:1508059064
Name:BRATCHER, SUSAN RAE (LCSW, ICAADC)
Entity Type:Individual
Prefix:MRS
First Name:SUSAN
Middle Name:RAE
Last Name:BRATCHER
Suffix:
Gender:F
Credentials:LCSW, ICAADC
Other - Prefix:
Other - First Name:SUSAN
Other - Middle Name:ADAMS
Other - Last Name:KILMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ADAMS: KILMAN
Mailing Address - Street 1:3440 PATCH RD
Mailing Address - Street 2:
Mailing Address - City:JBSA FT SAM HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:78234-2547
Mailing Address - Country:US
Mailing Address - Phone:501-733-5388
Mailing Address - Fax:
Practice Address - Street 1:3440 PATCH RD
Practice Address - Street 2:
Practice Address - City:JBSA FT SAM HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:78234-2547
Practice Address - Country:US
Practice Address - Phone:501-733-5388
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-19
Last Update Date:2021-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARA-020101YA0400X
AR1571-C104100000X
TX687131041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No104100000XBehavioral Health & Social Service ProvidersSocial Worker