Healthcare Provider Details
I. General information
NPI: 1497015804
Provider Name (Legal Business Name): WINNIE BRUTUS BIEN AIME MA, LPC, BCC
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 05/18/2012
Last Update Date: 07/24/2023
Certification Date: 07/24/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1389 ENTRANCE RD STE F
LEESVILLE LA
71446-8820
US
IV. Provider business mailing address
3300 ARCTIC BLVD STE 201 #1005
ANCHORAGE AK
99503-1182
US
V. Phone/Fax
- Phone: 337-221-4596
- Fax:
- Phone: 561-601-6345
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 101YP2500X |
| Taxonomy | Professional Counselor |
| License Number | 162360 |
| License Number State | AK |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 101YP2500X |
| Taxonomy | Professional Counselor |
| License Number | 8659 |
| License Number State | LA |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 101YM0800X |
| Taxonomy | Mental Health Counselor |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: