Provider Demographics
NPI:1902129422
Name:BRANA, MARK LOUIS (LCPC, LCADC)
Entity Type:Individual
Prefix:MR
First Name:MARK
Middle Name:LOUIS
Last Name:BRANA
Suffix:
Gender:M
Credentials:LCPC, LCADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2520 SAINT ROSE PKWY STE 209
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89074-7787
Mailing Address - Country:US
Mailing Address - Phone:702-475-1649
Mailing Address - Fax:702-558-9928
Practice Address - Street 1:2520 SAINT ROSE PKWY
Practice Address - Street 2:SUITE 202D
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89074-7783
Practice Address - Country:US
Practice Address - Phone:702-475-1649
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-03-11
Last Update Date:2019-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV00408-LC101YA0400X
NVCP0197101YM0800X
NVCI0139101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV1902129422Medicaid