Healthcare Provider Details

I. General information

NPI: 1821955949
Provider Name (Legal Business Name): BRAVE HEART CHILD & FAMILY COUNSELING INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/09/2026
Last Update Date: 01/09/2026
Certification Date: 01/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12625 HIGH BLUFF DR STE 220
SAN DIEGO CA
92130-2054
US

IV. Provider business mailing address

PO BOX 2851
DEL MAR CA
92014-5851
US

V. Phone/Fax

Practice location:
  • Phone: 858-376-7285
  • Fax:
Mailing address:
  • Phone: 858-376-7285
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: BELINDA LEE
Title or Position: PRESIDENT, SECRETARY, TREASURER
Credential: LMFT
Phone: 858-376-7285