Provider Demographics
NPI:1649311606
Name:BRAMWELL, TRACY (LPC)
Entity type:Individual
Prefix:
First Name:TRACY
Middle Name:
Last Name:BRAMWELL
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11312 FLETCHER HALL LN
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78717-4455
Mailing Address - Country:US
Mailing Address - Phone:512-257-2194
Mailing Address - Fax:
Practice Address - Street 1:13276 N HIGHWAY 183
Practice Address - Street 2:207
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78750-3236
Practice Address - Country:US
Practice Address - Phone:512-554-7825
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX60306101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional