Brave Soul Therapy, a Licensed Clinical Social Worker Professional Cor

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

BRAVE SOUL THERAPY, A LICENSED CLINICAL SOCIAL WORKER PROFESSIONAL COR

Practice address

245 McEvoy St
San Jose, CA 95126-4807

Phone

(408) 337-6473

Fax

(408) 352-6906

NPI assigned

Mar 21, 2024

Organization subpart

No

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

Authorized official

Name

Felicia Hermle, LCSWNPI 1437584646

Title

Ceo

Phone

(408) 337-6473

Specialties & licenses 1

Addresses

Other names 1

• Brave Soul Therapy Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Felicia Hermle, LCSW

  • Clinical Social Worker
  • San Jose, CA
  • NPI 1437584646
  NPD Authorized official

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

{
    "created_epoch": "1710979200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1710979200000",
    "number": "1346000783",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2108 N ST # 9001",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958165712",
            "telephone_number": "408-337-6473"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "245 MCEVOY ST",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951264807",
            "telephone_number": "408-337-6473",
            "fax_number": "408-352-6906"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRAVE SOUL THERAPY, A LICENSED CLINICAL SOCIAL WORKER PROFESSIONAL COR",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-03-21",
        "last_updated": "2024-03-21",
        "certification_date": "2024-03-21",
        "status": "A",
        "authorized_official_last_name": "HERMLE",
        "authorized_official_first_name": "FELICIA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "408-337-6473",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Brave Soul Therapy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Thaiz Brasil, PPD
• Steven Brass
• Beth L. Bratt, P.A-C
• Julianne Brauer, MPH, RD
• Bruce I Braunstein, CCP
• Gregory Braverman, M.D
• Claudia Bravo Medina
• Alondra Bravo
• Anisa Bravo, MD
• Anthony Andrew Bravo Sr.

• Clinical Social Worker in San Jose, CA
• Providers in San Jose, CA by specialty
• Clinical Social Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2024; 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.