Provider Demographics
NPI:1790838696
Name:BRAUN, STEPHANIE (MA, LMFT)
Entity Type:Individual
Prefix:MS
First Name:STEPHANIE
Middle Name:
Last Name:BRAUN
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 1:735 COMMERCE CENTER DR
Mailing Address - Street 2:SUITE A
Mailing Address - City:SEBASTIAN
Mailing Address - State:FL
Mailing Address - Zip Code:32958-3136
Mailing Address - Country:US
Mailing Address - Phone:772-589-4488
Mailing Address - Fax:772-589-9027
Practice Address - Street 1:735 COMMERCE CENTER DR
Practice Address - Street 2:SUITE A
Practice Address - City:SEBASTIAN
Practice Address - State:FL
Practice Address - Zip Code:32958-3136
Practice Address - Country:US
Practice Address - Phone:772-589-4488
Practice Address - Fax:772-589-9027
Is Sole Proprietor?:No
Enumeration Date:2007-01-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMT1486101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health