Provider Demographics
NPI:1528605714
Name:BRAKHANE, AARON SCOTT (LCSW)
Entity Type:Individual
Prefix:
First Name:AARON
Middle Name:SCOTT
Last Name:BRAKHANE
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:168 W UNIVERSITY PKWY
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:TN
Mailing Address - Zip Code:38305-1624
Mailing Address - Country:US
Mailing Address - Phone:731-300-0810
Mailing Address - Fax:
Practice Address - Street 1:168 W UNIVERSITY PKWY
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:TN
Practice Address - Zip Code:38305-1624
Practice Address - Country:US
Practice Address - Phone:731-300-0810
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-12-06
Last Update Date:2019-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN71681041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical