Provider Demographics
NPI:1053193235
Name:BRANSON, JAMES (QMHS)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:
Last Name:BRANSON
Suffix:
Gender:M
Credentials:QMHS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2211 W 36TH ST
Mailing Address - Street 2:
Mailing Address - City:LORAIN
Mailing Address - State:OH
Mailing Address - Zip Code:44053-2511
Mailing Address - Country:US
Mailing Address - Phone:440-320-7236
Mailing Address - Fax:
Practice Address - Street 1:628 POPLAR ST
Practice Address - Street 2:
Practice Address - City:ELYRIA
Practice Address - State:OH
Practice Address - Zip Code:44035-4065
Practice Address - Country:US
Practice Address - Phone:440-242-0056
Practice Address - Fax:216-334-2876
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-20
Last Update Date:2023-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Single Specialty