Organization
BRAVE THERAPY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN BOWEN NBCC (MENTAL HEALTH COUNSEL)
(508) 560-4400
Entity
Organization
Contact information
Practice address
455 STATE RD, VINEYARD HAVEN, MA 02568-5695
(508) 560-4400
Mailing address
455 STATE RD, VINEYARD HAVEN, MA 02568-5695
(508) 560-4400
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1285775
NATIONAL BOARD FOR CERTIFIED COUNSELORS
MA
Enumeration date
07/18/2022
Last updated
07/18/2022
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