| Brave Embodiment Counseling Llc | |
|
2590 Welton St Ste 200-1005 Denver CO 80205-3300 | |
| (240) 480-0152 | |
| Not Available |
| Full Name | Brave Embodiment Counseling Llc |
|---|---|
| Speciality | Counselor |
| Location | 2590 Welton St Ste 200-1005, Denver, Colorado |
| Authorized Official Name and Position | Kimberly Massale (OWNER) |
| Authorized Official Contact | 7209233033 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Brave Embodiment Counseling Llc 2590 Welton St Ste 200-1005 Denver CO 80205-3300 Ph: (720) 923-3033 | Brave Embodiment Counseling Llc 2590 Welton St Ste 200-1005 Denver CO 80205-3300 Ph: (240) 480-0152 |
| NPI Number | 1053828525 |
|---|---|
| Provider Enumeration Date | 01/05/2018 |
| Last Update Date | 08/18/2022 |
| Certification Date | 08/18/2022 |
| Medicare PECOS PAC ID | 6406217181 |
|---|---|
| Medicare Enrollment ID | O20230727001497 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053828525 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 104100000X | Social Worker | (* (Not Available)) | Secondary |
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
| Provider Name | Kimberly Ottinger Massale |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1235493073 PECOS PAC ID: 4789045469 Enrollment ID: I20240205000198 |
| Provider Name | Amy Catherine Reid |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1720400666 PECOS PAC ID: 9537504220 Enrollment ID: I20240305000062 |
| Provider Name | Taylor Palen |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1992356703 PECOS PAC ID: 9739525882 Enrollment ID: I20240311003928 |
| Provider Name | Jessica Marie Rowan |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1548663289 PECOS PAC ID: 6507203387 Enrollment ID: I20240328002461 |
| Provider Name | Janice Martindale |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1396336095 PECOS PAC ID: 3678911328 Enrollment ID: I20240401002599 |
| Provider Name | Carla Sephora Lopez |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1689167835 PECOS PAC ID: 4082052543 Enrollment ID: I20240402004213 |
| Provider Name | Sophia Rose Tornabene |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1386377026 PECOS PAC ID: 4880112143 Enrollment ID: I20250520001849 |
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