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General NPI Number Information
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NPI Number | 1124779111
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Entity Type | Organization
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Legal Business Name | BRIGHTER MINDS THERAPY
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Dates
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Enumeration Date | 01/12/2022
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Last Update Date | 03/04/2022
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Provider Practice Location Address
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Address Line | 4721 BRIANS WAY
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City | CHESAPEAKE
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State | VA
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Zip | 23321-4490
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Country | US
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Telephone | 720-295-9626
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Fax | 303-265-9416
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Provider Business Mailing Address
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Address Line | 4721 BRIANS WAY
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City | CHESAPEAKE
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State | VA
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Zip | 23321-4490
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Country | US
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Telephone | 720-295-9626
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Fax | 303-265-9416
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Authorized Official
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Title or Position | OWNER/CLINICIAN
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Name | RACHEL MARIE KIMBREL
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Credential | LCSW
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Telephone | 720-295-9626
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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