Active NPI
Brave Defiance Consulting LLC
- Community/Behavioral Health Agency
- Brooklyn Park, MN
National Provider Identifier
1003560681
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Behavioral Health Agency
- Legal business name
- BRAVE DEFIANCE CONSULTING LLC
- Practice address
- 6312 Welcome Ave N
Brooklyn Park, MN 55429-2047 - Phone
- (205) 451-7955
- NPI assigned
- Feb 11, 2022
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Aja Dionna King
- Title
- Ao
- Phone
- (205) 451-7955
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counseling Psychologist | 103TC1900X | |||
| Community/Behavioral Health Agency | 251S00000X | Primary |
Addresses
Primary practice location
6312 Welcome Ave N
Brooklyn Park, MN 55429-2047
Mailing address
6312 Welcome Ave N
Brooklyn Park, MN 55429-2047
Phone (612) 470-1783
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0 | Other | 0 |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | adkingaking@gmail.com |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MN
Enrollment records 1
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1644537600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1775174400000",
"number": "1003560681",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6312 WELCOME AVE N",
"city": "BROOKLYN PARK",
"state": "MN",
"postal_code": "554292047",
"telephone_number": "612-470-1783"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6312 WELCOME AVE N",
"city": "BROOKLYN PARK",
"state": "MN",
"postal_code": "554292047",
"telephone_number": "205-451-7955"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "BRAVE DEFIANCE CONSULTING LLC",
"organizational_subpart": "NO",
"enumeration_date": "2022-02-11",
"last_updated": "2026-04-03",
"certification_date": "2026-04-03",
"status": "A",
"authorized_official_last_name": "KING",
"authorized_official_first_name": "AJA",
"authorized_official_middle_name": "DIONNA",
"authorized_official_title_or_position": "AO",
"authorized_official_telephone_number": "205-451-7955"
},
"taxonomies": [
{
"code": "103TC1900X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Psychologist, Counseling",
"state": null,
"license": null,
"primary": false
},
{
"code": "251S00000X",
"taxonomy_group": "",
"desc": "Community/Behavioral Health",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "adkingaking@gmail.com",
"affiliation": "N",
"address_1": "6312 Welcome Ave N",
"city": "Brooklyn Park",
"state": "MN",
"country_code": "US",
"postal_code": "554292047",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Brooklyn Park, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.