Provider Demographics
NPI:1922367366
Name:D ROSS BRAUNE MA LPC AND ASSOCIATES
Entity Type:Organization
Organization Name:D ROSS BRAUNE MA LPC AND ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED PROFESSIONAL COUNSELOR
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:ROSS
Authorized Official - Last Name:BRAUNE
Authorized Official - Suffix:SR
Authorized Official - Credentials:LPC
Authorized Official - Phone:361-652-8470
Mailing Address - Street 1:111 WOODHAVEN DR
Mailing Address - Street 2:
Mailing Address - City:VICTORIA
Mailing Address - State:TX
Mailing Address - Zip Code:77904-1147
Mailing Address - Country:US
Mailing Address - Phone:361-652-8470
Mailing Address - Fax:361-572-8578
Practice Address - Street 1:401 BROADWAY AVE.
Practice Address - Street 2:100
Practice Address - City:CUERO
Practice Address - State:TX
Practice Address - Zip Code:77954
Practice Address - Country:US
Practice Address - Phone:361-652-8470
Practice Address - Fax:361-572-8578
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-04
Last Update Date:2012-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX16804101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX145729302Medicaid