Organization
BRAVE BEGINNINGS COUNSELING, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LATRICE WILLIS LCSW (SOCIAL WORKER)
(217) 979-9249
Entity
Organization
Contact information
Practice address
1619 S MATTIS AVE, CHAMPAIGN, IL 61821-5470
(217) 979-9249
Mailing address
1619 S MATTIS AVE, CHAMPAIGN, IL 61821-5470
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
10/22/2021
Last updated
10/22/2021
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