Provider Demographics
NPI:1023503125
Name:BRAUN, PHILLIP CURTIS JR (LMFT)
Entity type:Individual
Prefix:MR
First Name:PHILLIP
Middle Name:CURTIS
Last Name:BRAUN
Suffix:JR
Gender:M
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:198 ROPER MOUNTAIN ROAD EXT STE C
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29615-6912
Mailing Address - Country:US
Mailing Address - Phone:864-381-8321
Mailing Address - Fax:
Practice Address - Street 1:198 ROPER MOUNTAIN ROAD EXT SUITE C
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29615-1463
Practice Address - Country:US
Practice Address - Phone:864-381-8321
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-30
Last Update Date:2019-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC4700106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist