| Brave Counseling And Consultation Llc | |
|
1512 W 6th Ave Ste B Emporia KS 66801-2400 | |
| (620) 208-6577 | |
| (620) 412-8954 |
| Full Name | Brave Counseling And Consultation Llc |
|---|---|
| Speciality | Psychologist |
| Location | 1512 W 6th Ave Ste B, Emporia, Kansas |
| Authorized Official Name and Position | Tyson Prouse (OWNER) |
| Authorized Official Contact | 6207946635 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Brave Counseling And Consultation Llc 982 Road 220 Emporia KS 66801-7930 Ph: () - | Brave Counseling And Consultation Llc 1512 W 6th Ave Ste B Emporia KS 66801-2400 Ph: (620) 208-6577 |
| NPI Number | 1285356030 |
|---|---|
| Provider Enumeration Date | 09/16/2022 |
| Last Update Date | 09/16/2022 |
| Certification Date | 09/16/2022 |
| Medicare PECOS PAC ID | 0547631624 |
|---|---|
| Medicare Enrollment ID | O20230127002122 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1285356030 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | (* (Not Available)) | Primary |
| Provider Name | Emily L Prouse |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1932501467 PECOS PAC ID: 1456722537 Enrollment ID: I20230208000339 |
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