Active NPI
Alexa Elizabeth Bravis, LPC
- Professional Counselor
- Dunmore, PA
National Provider Identifier
1760107601
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- PC014839
- Practice address
- 1416 Monroe Ave Ste 204
Dunmore, PA 18509-2477 - Phone
- (570) 780-4505
- NPI assigned
- Oct 4, 2022
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | PC014839 | PA | Primary |
Addresses
Primary practice location
1416 Monroe Ave Ste 204
Dunmore, PA 18509-2477
Mailing address
1701 Monsey Ave
Scranton, PA 18509-1940
Phone (570) 947-0680
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PC014839 | PA | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| MMG Counseling LLC | Professional | Current | Accepting new patients |
Locations
1416 Monroe Ave
Ste 204
Dunmore, PA 18509
Phone (570) 249-9271
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1664841600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1664841600000",
"number": "1760107601",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1701 MONSEY AVE",
"city": "SCRANTON",
"state": "PA",
"postal_code": "185091940",
"telephone_number": "570-947-0680"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1416 MONROE AVE STE 204",
"city": "DUNMORE",
"state": "PA",
"postal_code": "185092477",
"telephone_number": "570-780-4505"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRAVIS",
"first_name": "ALEXA",
"middle_name": "ELIZABETH",
"credential": "LPC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-10-04",
"last_updated": "2022-10-04",
"certification_date": "2022-09-06",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "PA",
"license": "PC014839",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Dunmore, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 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.