Provider Demographics
NPI:1194150854
Name:BRAKE, EMILY MARGARET (LPC)
Entity type:Individual
Prefix:MRS
First Name:EMILY
Middle Name:MARGARET
Last Name:BRAKE
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:EMILY
Other - Middle Name:MARGARET
Other - Last Name:REESMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPCA
Mailing Address - Street 1:7222 BROOKBANK LN
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27615-5602
Mailing Address - Country:US
Mailing Address - Phone:434-403-7493
Mailing Address - Fax:
Practice Address - Street 1:249 E NC HIGHWAY 54
Practice Address - Street 2:SUITE 320
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27713-7512
Practice Address - Country:US
Practice Address - Phone:919-753-1080
Practice Address - Fax:919-753-1089
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-12
Last Update Date:2013-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC9071101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional