Individual
TONYA R BRANHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPCC, LMHC, LPC
Contact information
Practice address
110 E MAIN ST STE 103-109, GEORGETOWN, KY 40324-1780
(859) 533-6366
Mailing address
110 E MAIN ST STE 103-105, GEORGETOWN, KY 40324-1780
(859) 533-6366
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
261970
KY
101YM0800X
Mental Health Counselor
22602
FL
101YP2500X
Professional Counselor
261970
KY
101YP2500X
Professional Counselor
Primary
280850
KY
101YP2500X
Professional Counselor
9879
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100736670
—
KY
Enumeration date
04/27/2020
Last updated
12/29/2023
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