Provider Demographics
NPI:1588825004
Name:BRACE, JAMES ALLEN (LCSW-R)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:ALLEN
Last Name:BRACE
Suffix:
Gender:M
Credentials:LCSW-R
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:150 W 28TH ST
Mailing Address - Street 2:SUITE 1101B
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10001-6103
Mailing Address - Country:US
Mailing Address - Phone:917-513-3042
Mailing Address - Fax:
Practice Address - Street 1:150 W 28TH ST
Practice Address - Street 2:SUITE 1101B
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10001-6103
Practice Address - Country:US
Practice Address - Phone:917-513-3042
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-18
Last Update Date:2016-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0759931041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical