Provider Demographics
NPI:1861651515
Name:JOY BRAUNLICH LCSW PA
Entity Type:Organization
Organization Name:JOY BRAUNLICH LCSW PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT & CEO
Authorized Official - Prefix:
Authorized Official - First Name:JOY
Authorized Official - Middle Name:
Authorized Official - Last Name:BRAUNLICH
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:704-713-7224
Mailing Address - Street 1:3751 WINDING CREEK LN
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28226-4839
Mailing Address - Country:US
Mailing Address - Phone:704-537-1633
Mailing Address - Fax:866-780-3596
Practice Address - Street 1:10720 CARMEL COMMONS BLVD
Practice Address - Street 2:SUITE 330
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28226-3785
Practice Address - Country:US
Practice Address - Phone:704-537-1633
Practice Address - Fax:866-780-3596
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-07
Last Update Date:2012-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0049821041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty