Healthcare Provider Details

I. General information

NPI: 1699698308
Provider Name (Legal Business Name): GOOD BEET WELLNESS PLCC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/31/2026
Last Update Date: 07/31/2026
Certification Date: 07/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1088 E CAPE ELIZABETH DR
NAMPA ID
83686-8511
US

IV. Provider business mailing address

1088 E CAPE ELIZABETH DR
NAMPA ID
83686-8511
US

V. Phone/Fax

Practice location:
  • Phone: 951-394-0510
  • Fax:
Mailing address:
  • Phone: 951-394-0510
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: BRANDY BERGREEN BROWN
Title or Position: MENTAL HEALTH THERAPIST
Credential: LPCC, LCPC, LPC, CPC
Phone: 951-394-0510