Bravo Wellness & Psychotherapy

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

BRAVO WELLNESS & PSYCHOTHERAPY

Practice address

400 Reservoir Ave Ste 3K
Providence, RI 02907-3565

Phone

(401) 830-2373

NPI assigned

Jan 9, 2025

Organization subpart

No

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

Authorized official

Name

Cecilia Calderon, LICSWNPI 1013599489

Title

President

Phone

(401) 830-2373

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in RI

Enrollment records 1

Locations

Practitioners 1

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

• Cecilia B Calderon, LICSW

  • Clinical Social Worker
  • Providence, RI
  • NPI 1013599489
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1736380800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1736380800000",
    "number": "1881404051",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 RESERVOIR AVE STE 3K",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029073565"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 RESERVOIR AVE STE 3K",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029073565",
            "telephone_number": "401-830-2373"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRAVO WELLNESS & PSYCHOTHERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-01-09",
        "last_updated": "2025-01-09",
        "certification_date": "2025-01-09",
        "status": "A",
        "authorized_official_last_name": "CALDERON",
        "authorized_official_first_name": "CECILIA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "401-830-2373",
        "authorized_official_credential": "LICSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Allyson Brathwaite-Gardner, PH.D
• Orrie Brauer, LCDP
• Tosca Braun, PHD
• Stephanie Gail Braunthal, DO
• India Michelle Braver
• Jose Javier Bravo Zanchez, M.D.
• Conor D. Bray, P.T., D.P.T
• Marlena-Ray Breault, LCDP,ACDP
• Victoria E Breda, LICSW
• Catherine Breen, M.D.

• Clinical Social Worker in Providence, RI
• Providers in Providence, RI by specialty
• Clinical Social Worker in Rhode Island

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2025; 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.