Carolyn Susanne Bradley, MS CCC SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

1055 Issued in NE

Practice address

4239 Farnam
Suite #509
Omaha, NE 68131

Phone

(402) 551-7338

NPI assigned

Aug 21, 2007

Last updated

Aug 21, 2007By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Laboratory of Speech and Language Disorders, Inc.

  • Speech-Language Pathologist
  • Omaha, NE
  • NPI 1124199419
  NPD (past)

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

{
    "created_epoch": "1187654400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1187654400000",
    "number": "1093908212",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1009 CREST RD",
            "city": "PAPILLION",
            "state": "NE",
            "postal_code": "68046",
            "telephone_number": "402-884-7893"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4239 FARNAM",
            "address_2": "SUITE #509",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "68131",
            "telephone_number": "402-551-7338"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRADLEY",
        "first_name": "CAROLYN",
        "middle_name": "SUSANNE",
        "name_prefix": "Mrs.",
        "credential": "MS CCC SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-08-21",
        "last_updated": "2007-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NE",
            "license": "1055",
            "primary": true
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "IA",
            "license": "001805",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anthony James Bradley, M.S.
• Ashley Bradley
• Ashley Larae Bradley, APRN CNP
• Aubree H Bradley, LPADC
• Barbara Nell Bradley, PT
• Corey Bradley
• De'Andre Bradley
• Halie Shea Bradley
• Joi Yokeesha Bradley
• Kelly Bradley

• Speech-Language Pathologist in Omaha, NE
• Providers in Omaha, NE by specialty
• Speech-Language Pathologist in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2007; 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.