Provider Demographics
NPI:1245363118
Name:BRAIMAH, R JUSTICE (PHD, LPC)
Entity type:Individual
Prefix:MR
First Name:R JUSTICE
Middle Name:
Last Name:BRAIMAH
Suffix:
Gender:M
Credentials:PHD, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10306 ELLISON CIR
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68134-1024
Mailing Address - Country:US
Mailing Address - Phone:402-515-4874
Mailing Address - Fax:402-344-8089
Practice Address - Street 1:1941 S 42ND ST
Practice Address - Street 2:SUITE 538
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68105-2939
Practice Address - Country:US
Practice Address - Phone:402-344-7000
Practice Address - Fax:402-344-8089
Is Sole Proprietor?:No
Enumeration Date:2007-03-13
Last Update Date:2022-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE7948101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health