Healthcare Provider Details
I. General information
NPI: 1992594014
Provider Name (Legal Business Name): BRAVE HOPE COUNSELING
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/05/2025
Last Update Date: 05/05/2025
Certification Date: 05/05/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
6640 GUNPARK DR STE 101
BOULDER CO
80301-7001
US
IV. Provider business mailing address
1601 29TH ST STE 12921209
BOULDER CO
80301-1009
US
V. Phone/Fax
- Phone: 720-340-1509
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 1041C0700X |
| Taxonomy | Clinical Social Worker |
| License Number | |
| License Number State | |
VII. Legacy identifiers
For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:
VIII. Authorized Official
Name:
DREW
FELDBAUM
Title or Position: OWNER/CLINICIAN
Credential: LCSW
Phone: 720-340-1509