Provider Demographics
NPI:1477234219
Name:BRAVE MINDS COUNSELING LLC
Entity Type:Organization
Organization Name:BRAVE MINDS COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/THERAPIST
Authorized Official - Prefix:MS
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:LEAH
Authorized Official - Last Name:MALONE
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:850-848-7162
Mailing Address - Street 1:3122 MAHAN DR STE 801-318
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32308-2500
Mailing Address - Country:US
Mailing Address - Phone:850-848-7162
Mailing Address - Fax:
Practice Address - Street 1:3122 MAHAN DR STE 801-318
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32308-2500
Practice Address - Country:US
Practice Address - Phone:850-848-7162
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-25
Last Update Date:2023-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)