Provider Demographics
NPI:1427942176
Name:BRACKEEN, CHAZ ELIZABETH
Entity type:Individual
Prefix:MRS
First Name:CHAZ
Middle Name:ELIZABETH
Last Name:BRACKEEN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:407 BENHAM CT
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:DE
Mailing Address - Zip Code:19711-6011
Mailing Address - Country:US
Mailing Address - Phone:203-690-0284
Mailing Address - Fax:
Practice Address - Street 1:407 BENHAM CT
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19711-6011
Practice Address - Country:US
Practice Address - Phone:203-690-0284
Practice Address - Fax:203-690-0284
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-06
Last Update Date:2025-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT72271041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical