Tinzley Juanita Bradford, WELLNESS COACH

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

052362191 Issued in GA

Practice address

1040 W Marietta St NW
Atlanta, GA 30318-5218

Phone

(770) 572-4239

NPI assigned

Oct 19, 2021

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Tinzley Juanita Bradford Professional name

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1634601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634601600000",
    "number": "1013670744",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2115 PIEDMONT RD NE APT 4108",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303244181",
            "telephone_number": "770-572-4239"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1040 W MARIETTA ST NW",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303185218",
            "telephone_number": "770-572-4239"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRADFORD",
        "first_name": "TINZLEY",
        "middle_name": "JUANITA",
        "credential": "WELLNESS COACH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-10-19",
        "last_updated": "2021-10-19",
        "certification_date": "2021-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "GA",
            "license": "052362191",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DRIVERS LICENSE",
            "identifier": "052362191",
            "state": "GA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Settlefree@protonmail.com",
            "affiliation": "N",
            "endpointDescription": "Service Address",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1040 W Marietta St NW",
            "city": "Atlanta",
            "state": "GA",
            "country_code": "US",
            "postal_code": "303185218",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "TINZLEY",
            "last_name": "BRADFORD",
            "middle_name": "JUANITA",
            "credential": "WELLNESS COACH",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Charles Shannon Bradford Jr., M.D.
• Kathleen Cuneo Bradford, NP
• Laetitia Bradford, PHARMD
• Lisa Bazzano Bradford, MA CCC-SLP
• Mary Anne Bradford, OT
• Bradley-Davino Psychological Associates, PC
• Bridget R. Bradley, RN
• Brittany Eleanor Bradley, CRNA
• Caitlin Bradley, MD
• Cinnamon D Bradley, MD

• Professional Counselor in Atlanta, GA
• Providers in Atlanta, GA by specialty
• Professional Counselor in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.