Provider Demographics
NPI:1083396709
Name:BEE BRAVE COUNSELING, LLC
Entity Type:Organization
Organization Name:BEE BRAVE COUNSELING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:NICOLE
Authorized Official - Last Name:RUSSO
Authorized Official - Suffix:
Authorized Official - Credentials:MS, LPC, NCC, RPT
Authorized Official - Phone:210-787-0865
Mailing Address - Street 1:1604 DAKOTA ST
Mailing Address - Street 2:
Mailing Address - City:NORMAN
Mailing Address - State:OK
Mailing Address - Zip Code:73069-6810
Mailing Address - Country:US
Mailing Address - Phone:210-787-0865
Mailing Address - Fax:
Practice Address - Street 1:2300 MCKOWN DR
Practice Address - Street 2:
Practice Address - City:NORMAN
Practice Address - State:OK
Practice Address - Zip Code:73072-6678
Practice Address - Country:US
Practice Address - Phone:405-321-3600
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-02
Last Update Date:2023-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty