Provider Demographics
NPI:1942471867
Name:BRAMMER, SHARON M (LPC)
Entity Type:Individual
Prefix:MS
First Name:SHARON
Middle Name:M
Last Name:BRAMMER
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:306 MCCLANAHAN AVE
Mailing Address - Street 2:SUITE A
Mailing Address - City:ROANOKE
Mailing Address - State:VA
Mailing Address - Zip Code:24014
Mailing Address - Country:US
Mailing Address - Phone:540-266-7418
Mailing Address - Fax:540-344-7154
Practice Address - Street 1:306 MCCLANAHAN AVE
Practice Address - Street 2:SUITE A
Practice Address - City:ROANOKE
Practice Address - State:VA
Practice Address - Zip Code:24014
Practice Address - Country:US
Practice Address - Phone:540-266-7418
Practice Address - Fax:540-344-7154
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-19
Last Update Date:2010-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701003742101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA010106494Medicaid
VA146787OtherANTHEM