Individual provider Active NPI

Sheila Rossana Bravo, M.S., L.M.H.C.

  • Counselor
  • Davie, FL
National Provider Identifier
1396065611
Registry record updated Jun 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
License
MH 10264 Issued in FL
Practice address
12555 Orange Dr
Suite 234
Davie, FL 33330-4304
Phone
(305) 298-4599
NPI assigned
Jun 9, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 28, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X MH 10264 FL Primary

Addresses

Primary practice location

12555 Orange Dr
Suite 234
Davie, FL 33330-4304

Mailing address

10282 SW 55TH Lane
Cooper City, FL 33328-5628
Phone (305) 298-4599

Other practice location 1

5124 Hollywood Blvd
Hollywood, FL 33021-6518
Phone (954) 894-1174

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
MH 10264FLMDCounselor

NPI Registry JSON

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

{
    "created_epoch": "1276041600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624838400000",
    "number": "1396065611",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10282 SW 55TH LANE",
            "city": "COOPER CITY",
            "state": "FL",
            "postal_code": "333285628",
            "telephone_number": "305-298-4599"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12555 ORANGE DR",
            "address_2": "SUITE 234",
            "city": "DAVIE",
            "state": "FL",
            "postal_code": "333304304",
            "telephone_number": "305-298-4599"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5124 Hollywood Blvd",
            "address_purpose": "LOCATION",
            "city": "Hollywood",
            "state": "FL",
            "postal_code": "330216518",
            "country_code": "US",
            "telephone_number": "954-894-1174",
            "fax_number": "954-965-4597",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BRAVO",
        "first_name": "SHEILA",
        "middle_name": "ROSSANA",
        "name_prefix": "Ms.",
        "credential": "M.S., L.M.H.C.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-06-09",
        "last_updated": "2021-06-28",
        "certification_date": "2021-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "FL",
            "license": "MH 10264",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Davie, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2021; 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.