Provider Demographics
NPI:1942311162
Name:BRAHM, JPYCE ANN (LPC)
Entity Type:Individual
Prefix:MS
First Name:JPYCE
Middle Name:ANN
Last Name:BRAHM
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:333 BISHOPS WAY
Mailing Address - Street 2:#125
Mailing Address - City:BROOKFIELD
Mailing Address - State:WI
Mailing Address - Zip Code:53005
Mailing Address - Country:US
Mailing Address - Phone:262-797-0315
Mailing Address - Fax:262-797-0358
Practice Address - Street 1:333 BISHOPS WAY
Practice Address - Street 2:#125
Practice Address - City:BROOKFIELD
Practice Address - State:WI
Practice Address - Zip Code:53005
Practice Address - Country:US
Practice Address - Phone:262-797-0315
Practice Address - Fax:262-797-0358
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI2905125104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI39795900Medicaid