NPIMap

Organization Active NPI

Bravo Psychological Group LLC.

  • Adult Mental Health Clinic/Center
  • Gaithersburg, MD
National Provider Identifier
1245975630
Registry record updated May 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X
Legal business name
BRAVO PSYCHOLOGICAL GROUP LLC.
Practice address
656 Quince Orchard Rd
Gaithersburg, MD 20878-1409
Phone
(301) 233-5020
NPI assigned
May 1, 2022
Last updated
May 1, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 1, 2022

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

Authorized official

Name
Eric W Bravo, PSY.D.NPI 1598034464
Title
Psychologist
Phone
(301) 233-5020

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Mental Health Clinic/Center 261QM0850X Primary

Addresses

Primary practice location

656 Quince Orchard Rd
Gaithersburg, MD 20878-1409

Mailing address

656 Quince Orchard Rd
Gaithersburg, MD 20878-1409
Phone (301) 233-5020

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1651363200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1651363200000",
    "number": "1245975630",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "656 QUINCE ORCHARD RD",
            "city": "GAITHERSBURG",
            "state": "MD",
            "postal_code": "208781409",
            "telephone_number": "301-233-5020",
            "fax_number": "240-912-9564"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "656 QUINCE ORCHARD RD",
            "city": "GAITHERSBURG",
            "state": "MD",
            "postal_code": "208781409",
            "telephone_number": "301-233-5020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRAVO PSYCHOLOGICAL GROUP LLC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-05-01",
        "last_updated": "2022-05-01",
        "certification_date": "2022-05-01",
        "status": "A",
        "authorized_official_last_name": "BRAVO",
        "authorized_official_first_name": "ERIC",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "PSYCHOLOGIST",
        "authorized_official_telephone_number": "301-233-5020",
        "authorized_official_credential": "PSY.D."
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gaithersburg, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2022; 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.