Organization Active NPI

Bravo Mental Wellness, PLLC

  • Adult Mental Health Clinic/Center
  • Apex, NC
National Provider Identifier
1861190035
Registry record updated Feb 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X
Legal business name
BRAVO MENTAL WELLNESS, PLLC
Practice address
916 Brittley Way
Apex, NC 27502-6438
Phone
(828) 776-5155
NPI assigned
Feb 17, 2023
Organization subpart
No

Authorized official

NPPES NPI Registry
Name
Sasha Bravo, MSNNPI 1841883030
Title
Pmhnp
Phone
(828) 776-5155

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Practitioners 1

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

National Provider Directory

National Provider Directory

Locations

174 Mine Lake Ct
Raleigh, NC 27615
Phone (919) 322-9723

Specialties & licenses 3

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X
Adult Mental Health Clinic/Center 261QM0850X Primary
Adolescent and Children Mental Health Clinic/Center 261QM0855X

Addresses

NPPES NPI Registry

Primary practice location

916 Brittley Way
Apex, NC 27502-6438

Mailing address

921 E Broad St Unit 1065
Fuquay Varina, NC 27526-1960
Phone (828) 776-5155

Other identifiers 1

NPPES NPI Registry
IdentifierTypeStateIssuer
1841883030OtherINDIVIDUAL NPI

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Feb 17, 2023.

{
    "created_epoch": "1676592000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1676592000000",
    "number": "1861190035",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "921 E BROAD ST UNIT 1065",
            "city": "FUQUAY VARINA",
            "state": "NC",
            "postal_code": "275261960",
            "telephone_number": "828-776-5155"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "916 BRITTLEY WAY",
            "city": "APEX",
            "state": "NC",
            "postal_code": "275026438",
            "telephone_number": "828-776-5155"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRAVO MENTAL WELLNESS, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-02-17",
        "last_updated": "2023-02-17",
        "certification_date": "2023-02-17",
        "status": "A",
        "authorized_official_last_name": "BRAVO",
        "authorized_official_first_name": "SASHA",
        "authorized_official_title_or_position": "PMHNP",
        "authorized_official_telephone_number": "828-776-5155",
        "authorized_official_credential": "MSN"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL NPI",
            "identifier": "1841883030",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Apex, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2023; 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.