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Individual

MS. JONETTA BRACKEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LCSW CSAC

Contact information

Practice address
3173 W SEXTON ST, SPRINGFIELD, MO 65810-1297
(262) 402-2494
Mailing address
1655 N MAYFAIR RD, MILWAUKEE, WI 53226-3076
(262) 402-2494

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
6801120163
MI
1041C0700X
Clinical Social Worker
2024047972
MO
1041C0700X
Clinical Social Worker
6801120163
MI
1041C0700X
Clinical Social Worker
Primary
8676-123
WI

Other

Enumeration date
06/21/2017
Last updated
03/09/2026
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