Provider Demographics
NPI:1811344427
Name:BRACH, ISAAC
Entity type:Individual
Prefix:
First Name:ISAAC
Middle Name:
Last Name:BRACH
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:206 WEBSTER AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11230-1106
Mailing Address - Country:US
Mailing Address - Phone:347-231-4471
Mailing Address - Fax:
Practice Address - Street 1:206 WEBSTER AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11230-1106
Practice Address - Country:US
Practice Address - Phone:347-231-4471
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-05-24
Last Update Date:2016-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
32429OtherMENTAL HEALTH COUNSELOR CASAC-T