Brace, Jim
Brace, Jim is an sole proprietor health care provider with primary practice located at 209 N Willow Ave , Tampa FL 33606-1333. He recently has only one registered license in Behavioral Health & Social Service Providers / Social Worker, which is considered as his primary health care specialty. Brace, Jim can be contacted via phone (813) 247-5433.Contact Information
Primary practice address
209 N Willow Ave
Tampa FL 33606-1333
Phone: (813) 247-5433
Fax: (813) 248-2141
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Social Worker | 104100000X | SW7075 | Florida |
Profile Details
| NPI number | 1184788705 |
|---|---|
| LBN Legal business name | Brace, Jim |
| Credentials | Licensed Clinical Social Worker (LCSW) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Dec 20th, 2006 |
| Last updated | Jul 9th, 2007 - about 17 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1184788705 | NPPES |
| Florida | Other | SW7075 | SOCIAL WORKER |
| Florida | MEDICAID | 766959300 | SOCIAL WORKER |
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