Provider Demographics
NPI:1285172577
Name:BRAINARD, ALLAN (LPCC-S)
Entity type:Individual
Prefix:
First Name:ALLAN
Middle Name:
Last Name:BRAINARD
Suffix:
Gender:M
Credentials:LPCC-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2648 MEDINA RD
Mailing Address - Street 2:
Mailing Address - City:MEDINA
Mailing Address - State:OH
Mailing Address - Zip Code:44256-9321
Mailing Address - Country:US
Mailing Address - Phone:440-570-2541
Mailing Address - Fax:330-201-6422
Practice Address - Street 1:2648 MEDINA RD
Practice Address - Street 2:
Practice Address - City:MEDINA
Practice Address - State:OH
Practice Address - Zip Code:44256-2378
Practice Address - Country:US
Practice Address - Phone:440-570-2541
Practice Address - Fax:440-201-6422
Is Sole Proprietor?:No
Enumeration Date:2017-02-07
Last Update Date:2024-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE003888101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health