MEDICARE: BRAVE COUNSELING SERVICES

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1851947097
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BRAVE COUNSELING SERVICES

Provider Business Mailing Address
First Line	:	9921 N NEVADA ST STE 103
Second Line	:
City	:	SPOKANE
State	:	WA
Zip	:	99218-1145
Country	:	US
Telephone Number	:	509-581-2690
Fax Number	:	509-593-8113

Provider Business Practice Location Address
First Line	:	9921 N NEVADA ST STE 103
Second Line	:
City	:	SPOKANE
State	:	WA
Zip	:	99218-1145
Country	:	US
Telephone Number	:	509-581-2690
Fax Number	:	509-593-8113

Authorized Official
Title or Position	:	OWNER
Name	:	KYLIE CHAFFIN
Credential	:	LMHC
Telephone Number	:	509-242-9696

Provider Enumeration Date	:	08/14/2019
Last Update Date	:	03/14/2025

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