| Brave North Therapy, Lcsw, Pllc | |
|
2693 E. Brutus Street Weedsport NY 13166 | |
| (315) 834-2014 | |
| Not Available |
| Full Name | Brave North Therapy, Lcsw, Pllc |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 2693 E. Brutus Street, Weedsport, New York |
| Authorized Official Name and Position | Kimberly Fortin (OWNER) |
| Authorized Official Contact | 3158342014 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Brave North Therapy, Lcsw, Pllc Po Box 1241 Weedsport NY 13166-1241 Ph: (315) 834-2014 | Brave North Therapy, Lcsw, Pllc 2693 E. Brutus Street Weedsport NY 13166 Ph: (315) 834-2014 |
| NPI Number | 1285422881 |
|---|---|
| Provider Enumeration Date | 04/25/2025 |
| Last Update Date | 04/25/2025 |
| Certification Date | 04/17/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1285422881 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |