Individual provider · Type 1 NPI
Michael Dean Brakeall Jr., LCDC II
Addiction (Substance Use Disorder) Counselor · Dayton, OH
NPI number
1063922490
Active
Practice location
1 Elizabeth Pl
Dayton, OH 45417-3445
Other practice locations
- 3095 Kettering Blvd, Moraine, OH 45439-1983 · (937) 293-8300
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 150053 (OH) |
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | CDCA.150053 (OH) |
| Case Manager/Care Coordinator | 171M00000X | None listed |
| Addiction (Substance Use Disorder) Counselor Primary | 101YA0400X | 162011 (OH) |
Addiction (Substance Use Disorder) Counselor: Definition to come...
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About NPI 1063922490
Michael Dean Brakeall Jr., LCDC II's National Provider Identifier is 1063922490, issued on Oct 12, 2017. The primary taxonomy on file is Addiction (Substance Use Disorder) Counselor (101YA0400X), and the practice location is in Dayton, OH. The record was last updated on May 21, 2024.