Brain Spa de LLC

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

BRAIN SPA DE LLC

Practice address

410 Foulk Rd Ste 105
Wilmington, DE 19803-3835

Phone

(302) 312-9478

NPI assigned

Jan 18, 2021

Last updated

Jan 18, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Sandeep GuptaNPI 1972577005

Title

Owner

Phone

(302) 478-6199

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in DE

Enrollment records 1

Practitioners 21

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.

• Sandeep Gupta, MD

  • Psychiatry Physician
  • Wilmington, DE
  • NPI 1972577005
  Medicare reassignment Care Compare group NPD Authorized official
• Janet Brown, APRN

  • Psychiatric/Mental Health Nurse Practitioner
  • Wilmington, DE
  • NPI 1043290638
  Medicare reassignment Care Compare group NPD
• Michelle Lauer, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Wilmington, DE
  • NPI 1013483627
  Medicare reassignment Care Compare group NPD
• Paul Sheslow, NP

  • Psychiatric/Mental Health Nurse Practitioner
  • Wilmington, DE
  • NPI 1295201994

  Single Specialty

  Medicare reassignment Care Compare group NPD
• James Lee Baier, MD, MPH

  • Psychiatry Physician
  • New Haven, CT
  • NPI 1285122069

  DE

  Medicare reassignment Care Compare group NPD
• Gobind Kang-Chahal, MD

  • Psychiatry Physician
  • Waukesha, WI
  • NPI 1265533392

  DE

  Medicare reassignment Care Compare group NPD
• Alfred E Bacon III, MD

  • Infectious Disease Physician
  • Newark, DE
  • NPI 1902967508
  NPD (past)
• Michelle Kathleen Bell, P.A.-C

  • Physician Assistant
  • Newark, DE
  • NPI 1508112608
  NPD (past)
• David M Cohen, M.D.

  • Infectious Disease Physician
  • Newark, DE
  • NPI 1306907902
  NPD (past)
• Kristen Leigh Facciolo

  • Infectious Disease Physician
  • Newark, DE
  • NPI 1487914834
  NPD (past)
• Tara Marie Frye, PA-C

  • Medical Physician Assistant
  • Newark, DE
  • NPI 1417575549
  NPD (past)
• Jacinta Hollinger, PA-C

  • Medical Physician Assistant
  • Newark, DE
  • NPI 1457702177
  NPD (past)

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

{
    "created_epoch": "1610928000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1610928000000",
    "number": "1861081499",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 HARBISON WAY",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292123422",
            "telephone_number": "803-768-4348"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "410 FOULK RD STE 105",
            "city": "WILMINGTON",
            "state": "DE",
            "postal_code": "198033835",
            "telephone_number": "302-312-9478"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRAIN SPA DE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-01-18",
        "last_updated": "2021-01-18",
        "certification_date": "2021-01-18",
        "status": "A",
        "authorized_official_last_name": "GUPTA",
        "authorized_official_first_name": "SANDEEP",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "302-478-6199"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cynthia S. Bradley, D.M.D.
• Erik S Bradley, DDS
• Megan Brady, DPT
• Shannon Brady
• Sherrie S Brady, PA-C
• Alexa M Brancato, D.M.D.
• Branch Behavioral Health LLC
• Kira Branch, PSY.D.
• Branches of Life Counseling, Inc
• Branching Out Occupational Therapy

• Mental Health Clinic/Center (Including Community Mental Health Center) in Wilmington, DE
• Providers in Wilmington, DE by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Delaware

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.