Provider Demographics
NPI:1275857955
Name:BRAINSAKE, LLC
Entity Type:Organization
Organization Name:BRAINSAKE, LLC
Other - Org Name:BRAIN WELLNESS AND BIOFEEDBACK CENTER OF WASHINGTON, LLC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:DIANE
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:BADGER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-215-7721
Mailing Address - Street 1:7910 WOODMONT AVE
Mailing Address - Street 2:SUITE 305
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20814-2519
Mailing Address - Country:US
Mailing Address - Phone:301-215-7721
Mailing Address - Fax:301-215-7718
Practice Address - Street 1:7910 WOODMONT AVE
Practice Address - Street 2:SUITE 305
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20814-2519
Practice Address - Country:US
Practice Address - Phone:301-215-7721
Practice Address - Fax:301-215-7718
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-24
Last Update Date:2015-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty