Provider Demographics
NPI:1528239167
Name:BRANA, BLANCA IVONNE (LCPC)
Entity type:Individual
Prefix:
First Name:BLANCA
Middle Name:IVONNE
Last Name:BRANA
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5470 HARPERS FARM RD APT A3
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MD
Mailing Address - Zip Code:21044-1233
Mailing Address - Country:US
Mailing Address - Phone:301-323-5367
Mailing Address - Fax:877-200-5447
Practice Address - Street 1:11249 LOCKWOOD DR STE C
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20901-4564
Practice Address - Country:US
Practice Address - Phone:301-323-5367
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-21
Last Update Date:2019-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLC3735101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional