Provider Demographics
NPI:1902196579
Name:BRANCO, STEVEN (LPCC)
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:
Last Name:BRANCO
Suffix:
Gender:M
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2323 BENJAMIN ST NE
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55418-4001
Mailing Address - Country:US
Mailing Address - Phone:612-386-2021
Mailing Address - Fax:
Practice Address - Street 1:2323 BENJAMIN ST NE
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55418-4001
Practice Address - Country:US
Practice Address - Phone:612-386-2021
Practice Address - Fax:612-454-2165
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-15
Last Update Date:2016-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN553101YM0800X, 101Y00000X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional