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BRAVE WINGS THERAPY, PC
NPI 1497304430
Clinic/Center - Multi-Specialty in Fairfield, NJ

Active since September 11, 2019
155 PASSAIC AVE, FAIRFIELD, NJ 07004(973) 747-0456 Get Directions Write a Review

NPPES record last updated: April 23, 2026. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Apr 23, 2026, Oct 2, 2020, Sep 11, 2019 (3 updates tracked since 2019).

About Brave Wings Therapy, Pc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

BRAVE WINGS THERAPY, PC (NPI 1497304430) is a healthcare organization registered as a multi-specialty in Fairfield, New Jersey and active in the NPI registry since September 2019. The organization lists Jennifer D. Moore, Owner, as its authorized official.

NPPES Registry Identity

NPI1497304430
Entity TypeOrganization
Primary Taxonomy261QM1300X
Legal Business NameBRAVE WINGS THERAPY, PC
Location Address155 PASSAIC AVEFairfield, NJ 07004-3561
Mailing Address155 Passaic AveFairfield, NJ 07004-3561 · (973) 747-0456
Phone(973) 747-0456
Organization SubpartNo
Authorized OfficialJennifer D. MooreOwner · (973) 747-0456
Enumeration DateSeptember 11, 2019
Last NPPES UpdateApril 23, 20263 updates tracked since enumeration
NPPES CertifiedApril 23, 2026
✔ NPI 1497304430 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyClinic/Center · Multi-SpecialtyAmbulatory Health Care Facilities
Taxonomy Code261QM1300X
Also ListedOccupational Therapist · PediatricsTaxonomy 225XP0200X
Also ListedSpeech-Language PathologistTaxonomy 235Z00000X
155 PASSAIC AVE, Fairfield, NJ 07004
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Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Other Providers at the Same Location NPPES 5

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MARIA KOUTSOUMBIS MS, CCC-SLP
Speech-Language Pathologist
155 PASSAIC AVE
FAIRFIELD, NJ 07004
Essex County (973) 800-8515
BROOKE KEENA
Occupational Therapist (Pediatrics)
155 PASSAIC AVE
FAIRFIELD, NJ 07004
Essex County (973) 800-8515
KERRY HALPIN OTD, OTR/L
Occupational Therapist
155 PASSAIC AVE
FAIRFIELD, NJ 07004
Essex County (973) 800-8515
GABRIELLA FERROVECCHIO OTD
Occupational Therapist
155 PASSAIC AVE
FAIRFIELD, NJ 07004
Essex County (973) 800-8515
MISS LAUREN N SCHAEFER
Speech-Language Pathologist
155 PASSAIC AVE
FAIRFIELD, NJ 07004
Essex County (973) 800-8515

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Brave Wings Therapy, PC's NPI number?

The NPI number for Brave Wings Therapy, PC is 1497304430. It was assigned to this organization in the NPPES registry on September 11, 2019.

Where is Brave Wings Therapy, PC located?

Brave Wings Therapy, PC is located at 155 Passaic Ave, Fairfield, NJ 07004. The listed phone number is (973) 747-0456.

What is Brave Wings Therapy, PC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Multi-Specialty, with taxonomy code 261QM1300X.

When was this NPI record last updated?

The NPPES record for Brave Wings Therapy, PC was last updated on April 23, 2026. NPI Profile syncs with the weekly NPPES data releases published by CMS.