Provider Demographics
NPI:1568688745
Name:BRASCH, JULIE (MA, LMFT)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:
Last Name:BRASCH
Suffix:
Gender:F
Credentials:MA, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:333 2ND ST NW
Mailing Address - Street 2:
Mailing Address - City:HICKORY
Mailing Address - State:NC
Mailing Address - Zip Code:28601-4904
Mailing Address - Country:US
Mailing Address - Phone:828-315-9950
Mailing Address - Fax:828-322-6305
Practice Address - Street 1:333 2ND ST NW
Practice Address - Street 2:
Practice Address - City:HICKORY
Practice Address - State:NC
Practice Address - Zip Code:28601-4904
Practice Address - Country:US
Practice Address - Phone:828-315-9950
Practice Address - Fax:828-322-6305
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC853106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC131K7OtherBCBSNC
NC221188OtherCOMPSYCH
NCC1547OtherMEDCOST
NC383033OtherTRICARE
NC2089183OtherCIGNA BEHAVIORAL
NC6105037Medicaid
NC7545866OtherAETNA