Brake, Burnett L
Brake, Burnett L is an sole proprietor health care provider with primary practice located at 1511 Washington St E , Charleston WV 25311-2505. He recently has only one registered license in Other Service Providers / Peer Specialist, which is considered as his primary health care specialty. Brake, Burnett L can be contacted via phone (304) 741-7106.Contact Information
Primary practice address
1511 Washington St E
Charleston WV 25311-2505
Phone: (304) 741-7106
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Other Service Providers / Peer Specialist | 175T00000X | West Virginia |
Profile Details
| NPI number | 1801509997 |
|---|---|
| LBN Legal business name | Brake, Burnett L |
| Credentials | PRSS |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jan 4th, 2023 |
| Last updated | Jan 4th, 2023 - about 2 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 | 1801509997 | NPPES |
| West Virginia | MEDICAID | 175T00000X |
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