Provider Demographics
NPI:1942859095
Name:THE BRACKETTE FIRM LLC
Entity Type:Organization
Organization Name:THE BRACKETTE FIRM LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER AND PRINCIPAL CONSULTANT
Authorized Official - Prefix:DR
Authorized Official - First Name:CAROLINE
Authorized Official - Middle Name:M
Authorized Official - Last Name:BRACKETTE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:404-303-1864
Mailing Address - Street 1:PO BOX 420634
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30342-0634
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2002 SUMMIT BLVD
Practice Address - Street 2:STE 300
Practice Address - City:BROOKHAVEN
Practice Address - State:GA
Practice Address - Zip Code:30319
Practice Address - Country:US
Practice Address - Phone:404-303-1864
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-09-10
Last Update Date:2019-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty