Brave Space Therapy, LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

BRAVE SPACE THERAPY, LLC

Practice address

1600 Hamilton St
Allentown, PA 18102-4214

Phone

(845) 807-6582

NPI assigned

May 23, 2022

Organization subpart

No

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

Authorized official

Name

Annalisa Bova, LCSW

Title

Owner

Phone

(845) 807-6582

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1653264000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1653264000000",
    "number": "1821736588",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8108 HERITAGE DR",
            "city": "ALBURTIS",
            "state": "PA",
            "postal_code": "180112721",
            "telephone_number": "845-807-6582"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 HAMILTON ST",
            "city": "ALLENTOWN",
            "state": "PA",
            "postal_code": "181024214",
            "telephone_number": "845-807-6582"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRAVE SPACE THERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-05-23",
        "last_updated": "2022-05-23",
        "certification_date": "2022-05-23",
        "status": "A",
        "authorized_official_last_name": "BOVA",
        "authorized_official_first_name": "ANNALISA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "845-807-6582",
        "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": []
}

• Kyle Alan Brandon, DPT
• Nicole Elizabeth Brandstetter, OTR
• Melissa L. Brannen, MD
• Lance Allen Branton, DDS
• Jessica Bratt
• Maria I Braxmeier, PT
• Courtney Braxton, LSW, LCADC
• Melissa Bready, PA-C
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• Breathe and Be Well, LLC

• All providers in Allentown, PA
• Clinical Social Worker in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 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.