DR. CAROLINE M. BRACKETTE (NPI# 1760993984) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1760993984 |
| Entity Type | Individual |
| Full Name | DR. CAROLINE M. BRACKETTE |
| Credential | PH.D., LPC, ACS |
| Practice Address |
2002 Summit Blvd Ste 300 Brookhaven GA 30319 |
| Mailing Address |
2002 Summit Blvd Ste 300 Brookhaven GA 30319-6422 |
| Practice Telephone | 4043031864 |
| Enumeration Date | 2017-10-15 |
| Last Update Date | 2019-09-13 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 101Y00000X | Counselor | LPC005580 | GA | Behavioral Health & Social Service Providers |
| Y | 101YM0800X |
Counselor Specialization: Mental Health |
LPC005580 | GA | Behavioral Health & Social Service Providers |
| N | 101YP2500X |
Counselor Specialization: Professional |
LPC005580 | GA | Behavioral Health & Social Service Providers |
| N | 101YS0200X |
Counselor Specialization: School |
867988 | GA | Behavioral Health & Social Service Providers |
| Street Address |
2002 SUMMIT BLVD STE 300 |
| City | BROOKHAVEN |
| State | GA |
| Zip Code | 30319 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629600424 | Seniorwell of Georgia, LLC | Dentist | 2002 Summit Blvd Ste 300, Brookhaven, GA 30319-6422 | 2020-02-10 |
| 1689206559 | Seniorwell of Georgia, LLC | Audiologist | 2002 Summit Blvd Ste 300, Brookhaven, GA 30319-6422 | 2020-02-10 |
| 1952818288 | Epic Solutions Inc | General Practice | 2002 Summit Blvd Ste 300, Brookhaven, GA 30319-6403 | 2018-01-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215556717 | Ronika Cotton | Marriage & Family Therapist | 2002 Summit Boulevard, Suite 300, Atlanta, GA 30319 | 2020-04-14 |
| 1093369548 | Gordon Peace | Physical Therapist | 705 Town Blvd Ne S 550, Atlanta, GA 30319 | 2019-08-01 |
| 1124682281 | Tiffany Nicole Blamble | Physician Assistant | 2235 Briarwood Way Ne, Brookhaven, GA 30319 | 2019-04-24 |
| 1891286860 | Sandy Springs Center for Urologic Surgery LLC | Clinic/Center | 1450 S Johnson Ferry Rd Ste 100, Atlanta, GA 30319 | 2018-05-24 |
| 1578070355 | Aaron Knott | Physical Therapist | 4260 Peachtree Road, Atlanta, GA 30319 | 2018-01-03 |
| 1639683832 | Lauren Hamann | Physical Therapist | 3777 Peachtree Rd Ne Apt 933, Brookhaven, GA 30319 | 2017-11-27 |
| 1700328713 | Christina Head | Counselor | 1350 Dresden Drive, Atlanta, GA 30319 | 2016-11-08 |
| 1528432572 | Hillary Allyn Olivier | Occupational Therapist | 3747 Peachtree Rd, Atlanta, GA 30319 | 2015-11-13 |
| 1285025304 | Karl Weismantel | Physical Therapy Assistant | 1000 Lenox Park Blvd, Atlanta, GA 30319 | 2015-02-11 |
| 1285938704 | Marc Todd Rutherford | Pharmacist | 104 Town Blvd, Atlanta, GA 30319 | 2010-12-23 |
| Find all providers in zip 30319 | ||||
| Taxonomy Code | 101YM0800X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801496864 | Poonam A Patel | Counselor | 2916 Clairmont Rd Ne Apt 2413, Brookhaven, GA 30329-4476 | 2020-10-29 |
| 1811502974 | Cheryl D Walker | Counselor | 2801 Buford Hwy Ne Ste 195, Brookhaven, GA 30329-2124 | 2020-09-14 |
| 1780220962 | Marisa I Romo | Counselor | 2957 Clairmon Rd Ne, Brookhaven, GA 30329-4447 | 2019-11-21 |
| 1164995593 | Kersten Vanem | Counselor | 706 Highway 51 N, Brookhaven, MS 39601-2366 | 2019-01-08 |
| 1013247287 | Keynard Edouard | Counselor | 1219 Rainer Rd, Brookhaven, PA 19015-1935 | 2010-01-11 |
| 1730414939 | Sharron Lashawn Cross | Counselor | 2801 Buford Hwy Ne Ste 540, Brookhaven, GA 30329 | 2009-10-06 |
| 1295894699 | Elizabeth Katherine Deegan | Counselor | 4928 Shepard St., Brookhaven, PA 19015 | 2006-12-08 |
| 1336752195 | Suwanne Taquise Sancko | Counselor | 2801 Buford Hwy Ne Ste 540, Brookhaven, GA 30329-2143 | 2020-08-31 |
| 1275145187 | Taylor Mcclendon | Counselor | 2801 Buford Hwy Ne Ste T60, Brookhaven, GA 30329-2145 | 2020-08-21 |
| 1407497621 | Randall K Jones | Counselor | 706 Highway 51 N, Brookhaven, MS 39601-2366 | 2019-09-30 |
| Find all providers in BROOKHAVEN | ||||
| City | BROOKHAVEN |
| Zip Code | 30319 |
Please comment or provide details below to improve the information on DR. CAROLINE M. BRACKETTE.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.