Provider Demographics
NPI:1831546050
Name:BRACEWELL, ADAMA (LPC)
Entity type:Individual
Prefix:
First Name:ADAMA
Middle Name:
Last Name:BRACEWELL
Suffix:
Gender:
Credentials:LPC
Other - Prefix:
Other - First Name:ADAMA
Other - Middle Name:
Other - Last Name:BRACEWELL
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LPC
Mailing Address - Street 1:1989 N 63RD ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19151-2693
Mailing Address - Country:US
Mailing Address - Phone:267-562-2270
Mailing Address - Fax:
Practice Address - Street 1:1989 N 63RD ST
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19151-2693
Practice Address - Country:US
Practice Address - Phone:267-562-2270
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-17
Last Update Date:2025-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health