Brave Space Counseling & Consulting LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

BRAVE SPACE COUNSELING & CONSULTING LLC

Practice address

2950 W Chicago Ave
Chicago, IL 60622-4375

Phone

(312) 834-3490

NPI assigned

Jul 11, 2019

Organization subpart

No

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

Authorized official

Name

Diana Castillo

Title

Owner

Phone

(773) 490-7900

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1562803200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1562803200000",
    "number": "1942852801",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "433 W HARRISON ST # 8578",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606993916",
            "telephone_number": "773-490-7900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2950 W CHICAGO AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606224375",
            "telephone_number": "312-834-3490"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRAVE SPACE COUNSELING & CONSULTING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-07-11",
        "last_updated": "2019-07-11",
        "status": "A",
        "authorized_official_last_name": "CASTILLO",
        "authorized_official_first_name": "DIANA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "773-490-7900"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Morgan Braun, LCSW
• Susan C. Braun, NP
• Caitlin Brauneis, PA-C
• Sara Braunstein, D.O.
• Karen Brautigam
• Brave Talk Therapy PLLC
• Alexis Braverman, MD
• Jaime Braverman, MD
• Bravi Health Limited
• Lori Ann Bravi, M.S., OTR, BCPR, CLT

• Clinical Social Worker in Chicago, IL
• Providers in Chicago, IL by specialty
• Clinical Social Worker in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2019; 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.