Provider Demographics
NPI:1992884993
Name:BRAZA, JULENE MAE (LCSW)
Entity type:Individual
Prefix:MRS
First Name:JULENE
Middle Name:MAE
Last Name:BRAZA
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:PO BOX 189
Mailing Address - Street 2:
Mailing Address - City:WESTBROOK
Mailing Address - State:CT
Mailing Address - Zip Code:06498
Mailing Address - Country:US
Mailing Address - Phone:860-399-6162
Mailing Address - Fax:860-399-7898
Practice Address - Street 1:303 CHURCH STREET
Practice Address - Street 2:UNIT 2
Practice Address - City:GUILFORD
Practice Address - State:CT
Practice Address - Zip Code:06437
Practice Address - Country:US
Practice Address - Phone:203-458-0705
Practice Address - Fax:203-458-2076
Is Sole Proprietor?:No
Enumeration Date:2006-11-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0057331041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical