Provider Demographics
NPI:1508607797
Name:BRASWELL-PIPES, THOMAS RUSSELL III (CADCI)
Entity type:Individual
Prefix:MR
First Name:THOMAS
Middle Name:RUSSELL
Last Name:BRASWELL-PIPES
Suffix:III
Gender:M
Credentials:CADCI
Other - Prefix:MR
Other - First Name:THOMAS
Other - Middle Name:RUSSELL
Other - Last Name:BRASWELL
Other - Suffix:III
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1149 KAYE CT
Mailing Address - Street 2:
Mailing Address - City:BURLINGTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08016-2228
Mailing Address - Country:US
Mailing Address - Phone:856-571-5598
Mailing Address - Fax:
Practice Address - Street 1:761 CUTHBERT BLVD
Practice Address - Street 2:
Practice Address - City:CHERRY HILL
Practice Address - State:NJ
Practice Address - Zip Code:08002-3417
Practice Address - Country:US
Practice Address - Phone:856-890-9449
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-03
Last Update Date:2024-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ2023-000013101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)