Provider Demographics
NPI:1659597763
Name:BRASKI, KARLA M (LCSW)
Entity Type:Individual
Prefix:MS
First Name:KARLA
Middle Name:M
Last Name:BRASKI
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:310 STUNTZ AVE
Mailing Address - Street 2:SUITE 209
Mailing Address - City:ASHLAND
Mailing Address - State:WI
Mailing Address - Zip Code:54806-1986
Mailing Address - Country:US
Mailing Address - Phone:715-682-2007
Mailing Address - Fax:715-682-2007
Practice Address - Street 1:310 STUNTZ AVE
Practice Address - Street 2:SUITE 209
Practice Address - City:ASHLAND
Practice Address - State:WI
Practice Address - Zip Code:54806-1986
Practice Address - Country:US
Practice Address - Phone:715-682-2007
Practice Address - Fax:715-682-2007
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-17
Last Update Date:2013-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1065-1231041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI1659597763Medicaid
WI1659597763Medicaid