| Brave Soul Therapy, A Licensed Clinical Social Worker Professional Cor | |
|
245 Mcevoy St San Jose CA 95126-4807 | |
| (408) 337-6473 | |
| (408) 352-6906 |
| Full Name | Brave Soul Therapy, A Licensed Clinical Social Worker Professional Cor |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 245 Mcevoy St, San Jose, California |
| Authorized Official Name and Position | Felicia Hermle (CEO) |
| Authorized Official Contact | 4083376473 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Brave Soul Therapy, A Licensed Clinical Social Worker Professional Cor 2108 N St # 9001 Sacramento CA 95816-5712 Ph: (408) 337-6473 | Brave Soul Therapy, A Licensed Clinical Social Worker Professional Cor 245 Mcevoy St San Jose CA 95126-4807 Ph: (408) 337-6473 |
| NPI Number | 1346000783 |
|---|---|
| Provider Enumeration Date | 03/21/2024 |
| Last Update Date | 03/21/2024 |
| Certification Date | 03/21/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1346000783 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
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