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General NPI Number Information
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NPI Number | 1740637750
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Entity Type | Organization
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Legal Business Name | BRAVE CHOICES, INC.
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Dates
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Enumeration Date | 05/19/2016
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Last Update Date | 03/03/2025
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Provider Practice Location Address
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Address Line | 1575 7TH ST W STE 104
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City | SAINT PAUL
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State | MN
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Zip | 55102-4252
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Country | US
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Telephone | 612-889-7517
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Fax | 888-874-5711
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Provider Business Mailing Address
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Address Line | 1575 7TH ST W STE 104
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City | SAINT PAUL
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State | MN
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Zip | 55102-4252
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Country | US
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Telephone | 612-889-7517
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Fax | 888-874-5711
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Authorized Official
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Title or Position | MENTAL HEALTH COUNSELOR
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Name | HEATHER MARIE HOLT
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Credential | MSW, LICSW
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Telephone | 612-889-7517
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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 | 21742
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License Number State | MN
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