Provider Demographics
NPI:1366529646
Name:BRAVERMAN, CAROLYN ANN (LCPC)
Entity type:Individual
Prefix:MS
First Name:CAROLYN
Middle Name:ANN
Last Name:BRAVERMAN
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1110 W LAKE COOK RD
Mailing Address - Street 2:SUITE 160
Mailing Address - City:BUFFALO GROVE
Mailing Address - State:IL
Mailing Address - Zip Code:60089-1944
Mailing Address - Country:US
Mailing Address - Phone:847-520-0222
Mailing Address - Fax:847-520-3922
Practice Address - Street 1:1110 W LAKE COOK RD
Practice Address - Street 2:SUITE 160
Practice Address - City:BUFFALO GROVE
Practice Address - State:IL
Practice Address - Zip Code:60089-1944
Practice Address - Country:US
Practice Address - Phone:847-520-0222
Practice Address - Fax:847-520-3922
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180-003558101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health