Provider Demographics
NPI:1962848143
Name:BRAMBLETT, JAMES R JR (PHD LMHC)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:R
Last Name:BRAMBLETT
Suffix:JR
Gender:M
Credentials:PHD LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3201 SHAMROCK ST S STE 103
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32309-3349
Mailing Address - Country:US
Mailing Address - Phone:850-583-1963
Mailing Address - Fax:
Practice Address - Street 1:3201 SHAMROCK ST S STE 103
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32309-3349
Practice Address - Country:US
Practice Address - Phone:850-583-1963
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-15
Last Update Date:2024-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH3738101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health