Healthcare Provider Details

I. General information

NPI: 1578456711
Provider Name (Legal Business Name): BRAIN POWER COUNSELING SERVICES PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/29/2025
Last Update Date: 05/11/2026
Certification Date: 05/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

415 N STATE ST STE 101
HURRICANE UT
84737-2351
US

IV. Provider business mailing address

415 N STATE ST STE 101
HURRICANE UT
84737-2351
US

V. Phone/Fax

Practice location:
  • Phone: 617-877-1224
  • Fax:
Mailing address:
  • Phone: 617-877-1224
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State

VIII. Authorized Official

Name: AMANDA MICHELLE CAVICCHI
Title or Position: LMFT
Credential: LMFT
Phone: 617-877-1224