Provider Demographics
NPI:1912491135
Name:BRATTON, IMELDA NINNETTE (LPCC-S, RPT-S)
Entity Type:Individual
Prefix:DR
First Name:IMELDA
Middle Name:NINNETTE
Last Name:BRATTON
Suffix:
Gender:F
Credentials:LPCC-S, RPT-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:364 S HILL RD
Mailing Address - Street 2:
Mailing Address - City:VERSAILLES
Mailing Address - State:KY
Mailing Address - Zip Code:40383-8663
Mailing Address - Country:US
Mailing Address - Phone:270-779-6265
Mailing Address - Fax:
Practice Address - Street 1:364 S HILL RD
Practice Address - Street 2:
Practice Address - City:VERSAILLES
Practice Address - State:KY
Practice Address - Zip Code:40383-8663
Practice Address - Country:US
Practice Address - Phone:270-779-6265
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-20
Last Update Date:2018-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY104202101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health