# BRAVO MIND PSYCHIATRY PLLC

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

## Provider details

- **NPI number:** 1982440400
- **Authorized official:** JOHANNA VILLASENOR NARDINI MD (MANAGING MEMBER)
- **Authorized official phone:** (210) 201-2656

## Contact information

- **Practice address:** 4405 7TH AVE SE STE 200, LACEY, WA 98503-1055
- **Practice address phone:** (210) 201-2656
- **Mailing address:** 13423 BLANCO RD UNIT 3164, SAN ANTONIO, TX 78216-2187
- **Mailing address phone:** (210) 201-2656
- **Mailing address fax:** (863) 228-8489

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM0850X | Adult Mental Health Clinic/Center | — | NULL | — |
| 261QM0855X | Adolescent and Children Mental Health Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 07/03/2024
- **Last updated:** 12/29/2025