Provider Demographics
NPI:1679172019
Name:BRAVE WITHIN COUNSELING LLC
Entity Type:Organization
Organization Name:BRAVE WITHIN COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER, OWNER
Authorized Official - Prefix:
Authorized Official - First Name:HYON
Authorized Official - Middle Name:J
Authorized Official - Last Name:BACHMAN
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:757-746-4357
Mailing Address - Street 1:969 LACON DR
Mailing Address - Street 2:
Mailing Address - City:NEWPORT NEWS
Mailing Address - State:VA
Mailing Address - Zip Code:23608-2526
Mailing Address - Country:US
Mailing Address - Phone:757-746-4357
Mailing Address - Fax:757-517-0612
Practice Address - Street 1:11815 FOUNTAIN WAY STE 300
Practice Address - Street 2:
Practice Address - City:NEWPORT NEWS
Practice Address - State:VA
Practice Address - Zip Code:23606-4448
Practice Address - Country:US
Practice Address - Phone:844-502-7283
Practice Address - Fax:757-517-0612
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-17
Last Update Date:2022-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty