Provider Demographics
NPI:1578045720
Name:BRAVAS COUNSELING SERVICES-LCSW, PLLC
Entity Type:Organization
Organization Name:BRAVAS COUNSELING SERVICES-LCSW, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED CLINICAL SOCIAL WORKER
Authorized Official - Prefix:
Authorized Official - First Name:TAMEIKA
Authorized Official - Middle Name:L
Authorized Official - Last Name:HINTON
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW-R, BC-TMH
Authorized Official - Phone:845-590-8224
Mailing Address - Street 1:PO BOX 792
Mailing Address - Street 2:
Mailing Address - City:WAPPINGERS FALLS
Mailing Address - State:NY
Mailing Address - Zip Code:12590-0792
Mailing Address - Country:US
Mailing Address - Phone:845-590-8224
Mailing Address - Fax:845-440-0036
Practice Address - Street 1:1100 ROUTE 9
Practice Address - Street 2:
Practice Address - City:FISHKILL
Practice Address - State:NY
Practice Address - Zip Code:12524-2560
Practice Address - Country:US
Practice Address - Phone:845-243-7024
Practice Address - Fax:845-440-0036
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-09-04
Last Update Date:2018-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR0755231041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty