Provider Demographics
NPI:1770332900
Name:BRANIM MENTAL HEALTH SERVICES LLC
Entity type:Organization
Organization Name:BRANIM MENTAL HEALTH SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:BETHANY
Authorized Official - Middle Name:EVANS
Authorized Official - Last Name:BRANIM
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:318-308-4813
Mailing Address - Street 1:108 CONSTITUTION DR
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:LA
Mailing Address - Zip Code:71303-3521
Mailing Address - Country:US
Mailing Address - Phone:318-704-0640
Mailing Address - Fax:318-704-0642
Practice Address - Street 1:108 CONSTITUTION DR
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:LA
Practice Address - Zip Code:71303-3521
Practice Address - Country:US
Practice Address - Phone:318-704-0640
Practice Address - Fax:318-704-0642
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-20
Last Update Date:2024-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty