Provider Demographics
NPI:1518164318
Name:BRACHT, BETTY MCKAY (LCPC)
Entity Type:Individual
Prefix:
First Name:BETTY
Middle Name:MCKAY
Last Name:BRACHT
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 12301
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20908-0301
Mailing Address - Country:US
Mailing Address - Phone:301-871-1699
Mailing Address - Fax:301-871-1354
Practice Address - Street 1:966 HUNGERFORD DR
Practice Address - Street 2:SUITE 14A
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20850-1714
Practice Address - Country:US
Practice Address - Phone:301-871-1699
Practice Address - Fax:301-871-1354
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-27
Last Update Date:2010-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLCPC3429101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional