# BRAVO MENTAL WELLNESS PLLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1033819529
- **Authorized official:** SASHA BRAVO MSN (PMHNP)
- **Authorized official phone:** (828) 776-5155

## Contact information

- **Practice address:** 174 MINE LAKE CT STE 200, RALEIGH, NC 27615-6417
- **Practice address phone:** (919) 769-1910
- **Practice address fax:** (919) 214-5388
- **Mailing address:** 921 E BROAD ST \# 1065, FUQUAY VARINA, NC 27526-1960
- **Mailing address phone:** (828) 776-5155
- **Mailing address fax:** (919) 214-1327

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | — | Yes |

## Other

- **Enumeration date:** 03/06/2023
- **Last updated:** 04/12/2023

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 5014097 | NORTH CAROLINA BOARD OF NURSING NP LICENSE NUMBER | NC |