Organization Active NPI

Brakins Consulting & Psychological Services LLC

  • Psychologist
  • Minneapolis, MN
National Provider Identifier
1194938167
Registry record updated Sep 24, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
LP4105 Issued in MN
Legal business name
BRAKINS CONSULTING & PSYCHOLOGICAL SERVICES LLC
Practice address
2100 Plymouth Ave N
Suite #245
Minneapolis, MN 55411-3675
Phone
(612) 302-3140
Fax
(612) 436-5412
NPI assigned
May 7, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 24, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Bravada Mae Garrett-Akinsanya, PH.D.
Title
Clinical Psychologist
Phone
(612) 302-3140

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103T00000X LP4105 MN Primary

Addresses

Primary practice location

2100 Plymouth Ave N
Suite #245
Minneapolis, MN 55411-3675

Mailing address

13805 60TH Ave N
Plymouth, MN 55446-3583
Phone (612) 839-1449

Other identifiers 7

IdentifierTypeStateIssuer
990991046885OtherMNPREFERRED ONE
HP29938OtherMNHEALTHPARTNERS
239323900MedicaidMN
1033294962OtherMNPERSON NPI #
42653GAOtherMNGROUP- BCBS
113550OtherMNUCARE (BHP)
6168492OtherMNUNITED BEHAVIORAL HEALTH

National Provider Directory

National Provider Directory

Locations

4050 Olson Memorial Hwy
#195
Golden Valley, MN 55422
Phone (763) 522-0100

2100 Plymouth Ave N
#245
Minneapolis, MN 55411
Phone (612) 302-3140

Practitioners & affiliated clinicians

Practitioners 3

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": "1178496000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1443052800000",
    "number": "1194938167",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13805 60TH AVE N",
            "city": "PLYMOUTH",
            "state": "MN",
            "postal_code": "554463583",
            "telephone_number": "612-839-1449",
            "fax_number": "763-550-9398"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 PLYMOUTH AVE N",
            "address_2": "SUITE #245",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554113675",
            "telephone_number": "612-302-3140",
            "fax_number": "612-436-5412"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRAKINS CONSULTING & PSYCHOLOGICAL SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-07",
        "last_updated": "2015-09-24",
        "status": "A",
        "authorized_official_last_name": "GARRETT-AKINSANYA",
        "authorized_official_first_name": "BRAVADA",
        "authorized_official_middle_name": "MAE",
        "authorized_official_title_or_position": "CLINICAL PSYCHOLOGIST",
        "authorized_official_telephone_number": "612-302-3140",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist",
            "state": "MN",
            "license": "LP4105",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERRED ONE",
            "identifier": "990991046885",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHPARTNERS",
            "identifier": "HP29938",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "239323900",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PERSON NPI #",
            "identifier": "1033294962",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP- BCBS",
            "identifier": "42653GA",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UCARE (BHP)",
            "identifier": "113550",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED BEHAVIORAL HEALTH",
            "identifier": "6168492",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.