Provider Demographics
NPI:1922831148
Name:BRANTLEY, MICHAELA MARIE (MSW, SWC)
Entity type:Individual
Prefix:
First Name:MICHAELA
Middle Name:MARIE
Last Name:BRANTLEY
Suffix:
Gender:F
Credentials:MSW, SWC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8800 FOX DR STE 110
Mailing Address - Street 2:
Mailing Address - City:THORNTON
Mailing Address - State:CO
Mailing Address - Zip Code:80260-6880
Mailing Address - Country:US
Mailing Address - Phone:720-381-0072
Mailing Address - Fax:720-398-9645
Practice Address - Street 1:8800 FOX DR STE 110
Practice Address - Street 2:
Practice Address - City:THORNTON
Practice Address - State:CO
Practice Address - Zip Code:80260-6880
Practice Address - Country:US
Practice Address - Phone:720-381-0072
Practice Address - Fax:720-398-9645
Is Sole Proprietor?:No
Enumeration Date:2024-08-22
Last Update Date:2024-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COSWC.00000013971041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical