Brave Embodiment Counseling Llc | |
2590 Welton St Ste 200-1005 Denver CO 80205-3300 | |
(240) 480-0152 | |
Not Available |
Full Name | Brave Embodiment Counseling Llc |
---|---|
Speciality | Counselor |
Location | 2590 Welton St Ste 200-1005, Denver, Colorado |
Authorized Official Name and Position | Kimberly Massale (OWNER) |
Authorized Official Contact | 7209233033 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Brave Embodiment Counseling Llc 2590 Welton St Ste 200-1005 Denver CO 80205-3300 Ph: (720) 923-3033 | Brave Embodiment Counseling Llc 2590 Welton St Ste 200-1005 Denver CO 80205-3300 Ph: (240) 480-0152 |
NPI Number | 1053828525 |
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Provider Enumeration Date | 01/05/2018 |
Last Update Date | 08/18/2022 |
Certification Date | 08/18/2022 |
Medicare PECOS PAC ID | 6406217181 |
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Medicare Enrollment ID | O20230727001497 |
Identifier | Type | State | Issuer |
---|---|---|---|
1053828525 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
104100000X | Social Worker | (* (Not Available)) | Secondary |
Provider Name | Kimberly Ottinger Massale |
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Provider Type | Practitioner - Mental Health Counselor |
Provider Identifiers | NPI Number: 1235493073 PECOS PAC ID: 4789045469 Enrollment ID: I20240205000198 |
Provider Name | Amy Catherine Reid |
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Provider Type | Practitioner - Mental Health Counselor |
Provider Identifiers | NPI Number: 1720400666 PECOS PAC ID: 9537504220 Enrollment ID: I20240305000062 |
Provider Name | Jessica Marie Rowan |
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Provider Type | Practitioner - Mental Health Counselor |
Provider Identifiers | NPI Number: 1548663289 PECOS PAC ID: 6507203387 Enrollment ID: I20240328002461 |
Provider Name | Janice Martindale |
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Provider Type | Practitioner - Mental Health Counselor |
Provider Identifiers | NPI Number: 1396336095 PECOS PAC ID: 3678911328 Enrollment ID: I20240401002599 |
Provider Name | Carla Sephora Lopez |
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Provider Type | Practitioner - Mental Health Counselor |
Provider Identifiers | NPI Number: 1689167835 PECOS PAC ID: 4082052543 Enrollment ID: I20240402004213 |
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