Provider Demographics
NPI:1467348060
Name:BRASFIELD, TERRY II (LSW)
Entity type:Individual
Prefix:MR
First Name:TERRY
Middle Name:
Last Name:BRASFIELD
Suffix:II
Gender:M
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26963 MARSHALL DR N
Mailing Address - Street 2:
Mailing Address - City:SOUTH BEND
Mailing Address - State:IN
Mailing Address - Zip Code:46628-4606
Mailing Address - Country:US
Mailing Address - Phone:574-343-0124
Mailing Address - Fax:
Practice Address - Street 1:26963 MARSHALL DR N
Practice Address - Street 2:
Practice Address - City:SOUTH BEND
Practice Address - State:IN
Practice Address - Zip Code:46628-4606
Practice Address - Country:US
Practice Address - Phone:574-343-0124
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-18
Last Update Date:2025-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN33012740A104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker