Provider Demographics
NPI:1063159820
Name:BRAME, LATINA (LMSW)
Entity type:Individual
Prefix:
First Name:LATINA
Middle Name:
Last Name:BRAME
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26 ELM ST FL 2
Mailing Address - Street 2:
Mailing Address - City:SHELTON
Mailing Address - State:CT
Mailing Address - Zip Code:06484-3009
Mailing Address - Country:US
Mailing Address - Phone:203-913-6198
Mailing Address - Fax:
Practice Address - Street 1:PO BOX 320521
Practice Address - Street 2:
Practice Address - City:FAIRFIELD
Practice Address - State:CT
Practice Address - Zip Code:06825-0521
Practice Address - Country:US
Practice Address - Phone:475-777-2542
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-13
Last Update Date:2024-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT6266104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker