1184820235 NPI number — MS. ELIZABETH SUE STROM-BRAUGHTON LMHC

Table of content: MS. ELIZABETH SUE STROM-BRAUGHTON LMHC (NPI 1184820235)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1184820235 NPI number — MS. ELIZABETH SUE STROM-BRAUGHTON LMHC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
STROM-BRAUGHTON
Provider First Name:
ELIZABETH
Provider Middle Name:
SUE
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
LMHC
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
BRAUGHTON
Provider Other First Name:
ELIZABETH
Provider Other Middle Name:
SUE
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
LMHC
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1184820235
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/12/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1111 HELMSDALE DR.
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WESLEY CHAPEL
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33543-3914
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
813-765-6249
Provider Business Mailing Address Fax Number:
813-948-0788

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
24160 STATE RD 54
Provider Second Line Business Practice Location Address:
SUITE 5
Provider Business Practice Location Address City Name:
LUTZ
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33559-6766
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
813-765-6249
Provider Business Practice Location Address Fax Number:
813-948-0788
Provider Enumeration Date:
06/25/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 101YM0800X , with the licence number:  MH3182 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2025 www.npivalidator.com