Provider Demographics
NPI:1770260895
Name:BRAUN, CLAIRE WILMOTH (PHD, HSPP)
Entity type:Individual
Prefix:DR
First Name:CLAIRE
Middle Name:WILMOTH
Last Name:BRAUN
Suffix:
Gender:F
Credentials:PHD, HSPP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:805 W PINE ST
Mailing Address - Street 2:
Mailing Address - City:ZIONSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46077-1732
Mailing Address - Country:US
Mailing Address - Phone:317-331-8013
Mailing Address - Fax:
Practice Address - Street 1:1650 W OAK ST STE 110
Practice Address - Street 2:
Practice Address - City:ZIONSVILLE
Practice Address - State:IN
Practice Address - Zip Code:46077-3835
Practice Address - Country:US
Practice Address - Phone:317-973-8888
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-30
Last Update Date:2023-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN10227019103TS0200X
IN20043510A103T00000X
IN20043510B103TH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool
No103TH0100XBehavioral Health & Social Service ProvidersPsychologistHealth Service