Provider Demographics
NPI:1104173335
Name:BRANHAM, SUSAN HEATHER (LCSW)
Entity type:Individual
Prefix:
First Name:SUSAN
Middle Name:HEATHER
Last Name:BRANHAM
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1316 PATTON AVE STE D
Mailing Address - Street 2:
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28806-2652
Mailing Address - Country:US
Mailing Address - Phone:828-225-3100
Mailing Address - Fax:828-225-3604
Practice Address - Street 1:669 S HAYWOOD ST
Practice Address - Street 2:
Practice Address - City:WAYNESVILLE
Practice Address - State:NC
Practice Address - Zip Code:28786-6703
Practice Address - Country:US
Practice Address - Phone:828-456-2997
Practice Address - Fax:828-456-2996
Is Sole Proprietor?:No
Enumeration Date:2012-08-07
Last Update Date:2014-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical