Kathy Anna Bradshaw
Individual provider Active NPI Counselor · Florence, SC
NPI 1104947209 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1104947209
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Counselor 101Y00000X
- Practice address
- 730 S Dargan St
Florence, SC 29506-2563 - Phone
- (843) 661-4718
- NPI assigned
- Apr 3, 2007
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | Yes |
Addresses
Primary practice location
730 S Dargan St
Florence, SC 29506-2563
Mailing address
125 East Cheves Street
Florence, SC 29506-2526
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 376241 | Medicaid | SC |
Other providers in Florence, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.