| Brakins Consulting & Psychological Services Llc | |
|
2100 Plymouth Ave N Suite #245 Minneapolis MN 55411-3675 | |
| (612) 302-3140 | |
| (612) 436-5412 |
| Full Name | Brakins Consulting & Psychological Services Llc |
|---|---|
| Speciality | Psychologist |
| Location | 2100 Plymouth Ave N, Minneapolis, Minnesota |
| Authorized Official Name and Position | Bravada Mae Garrett-akinsanya (CLINICAL PSYCHOLOGIST) |
| Authorized Official Contact | 6123023140 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Brakins Consulting & Psychological Services Llc 13805 60th Ave N Plymouth MN 55446-3583 Ph: (612) 839-1449 | Brakins Consulting & Psychological Services Llc 2100 Plymouth Ave N Suite #245 Minneapolis MN 55411-3675 Ph: (612) 302-3140 |
| NPI Number | 1194938167 |
|---|---|
| Provider Enumeration Date | 05/07/2007 |
| Last Update Date | 09/24/2015 |
| Medicare PECOS PAC ID | 6103923693 |
|---|---|
| Medicare Enrollment ID | O20070517000331 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1194938167 | NPI | - | NPPES |
| 990991046885 | Other | MN | PREFERRED ONE |
| HP29938 | Other | MN | HEALTHPARTNERS |
| 239323900 | Medicaid | MN | |
| 1033294962 | Other | MN | PERSON NPI # |
| 42653GA | Other | MN | GROUP- BCBS |
| 113550 | Other | MN | UCARE (BHP) |
| 6168492 | Other | MN | UNITED BEHAVIORAL HEALTH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | LP4105 (Minnesota) | Primary |
| Provider Name | Bravada M Garrett-akinsanya |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1033294962 PECOS PAC ID: 6103923685 Enrollment ID: I20070517000318 |
| Provider Name | Pamela J Henderson |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1538169628 PECOS PAC ID: 2668654138 Enrollment ID: I20110305000065 |
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