Jae Brainard is a Clinical in Raleigh, North Carolina. Jae Brainard practices all healthcare services and medical treatments related to Clinical. The NPI Number for Jae Brainard is 1760501084. The last update date is 2007-07-08.
Jae Brainard's current location address is 5214 Western Blvd, Raleigh, North Carolina. You can contact this provider via phone number 9194810574 and fax number 9198513636. The mailing address for Jae Brainard is 5214 Western Blvd, Raleigh, North Carolina. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Jae Brainard |
|---|---|
| Address | 5214 Western Blvd, Raleigh, North Carolina |
| Phone Number | 9194810574 |
| Fax Number | 9198513636 |
| Sole Proprietor | Y |
| Credentials | LCSW |
NPI Number Detail
| NPI Number | 1760501084 |
|---|---|
| Provider Enumeration Date | 2007-03-28 |
| Last Updated Date | 2007-07-08 |
Provider Mailing Address Detail
| Address | 5214 Western Blvd |
|---|---|
| City | Raleigh |
| State | North Carolina (NC) |
| Post Code | 276061642 |
| Phone Number | 9194810574 |
| Fax Number | 9198513636 |
Provider's Primary Taxonomy Detail
| Speciality | Clinical |
|---|---|
| Taxonomy | 1041C0700X |
| Licence No | C002462 |
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Definition: A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certif |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 10607 | NC | BCBS |
Post Comment/ Review Below
What is the unique 10-digit identifier code assigned to Jae Brainard by the Centers for Medicare & Medicaid Services?
The Jae Brainard has been issued the NPI (National Provider Identifier) 1760501084 by the CMS (Centers for Medicare & Medicaid Services), which serves as a unique identification number for healthcare providers.
Can you provide the Jae Brainard's physical address?
The Jae Brainard is physically located at 5214 Western Blvd, in the city of Raleigh, NC, with the postal code 276061642.
What is Jae Brainard's specialized area of practice, and what is the corresponding taxonomy classification code for this field?
The Jae Brainard's specialized field of practice is Clinical, and the corresponding taxonomy code that categorizes this area of specialization is 1041C0700X.
On what date did the Centers for Medicare & Medicaid Services originally issue the 1760501084 to Jae Brainard?
The Centers for Medicare & Medicaid Services originally issued the 1760501084 to Jae Brainard on 2007-03-28.
When was the Jae Brainard's information last updated?
The Jae Brainard's information was last updated on 2007-07-08.
NPI Number: 1518960137
Address: 161 Sherman Dr, St Johnsbury, VT