Orange Tree Therapeutic Alliance, a LCSW Corporation

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

ORANGE TREE THERAPEUTIC ALLIANCE, A LCSW CORPORATION

Doing business as

Orange Tree Therapeutic Alliance / OTTA Therapy

Practice address

11801 Pierce St Ste 200
Riverside, CA 92505-4400

Phone

(951) 521-0802

NPI assigned

Mar 19, 2021

Last updated

Mar 19, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Troy Donavon Bradley II, MSW, LCSWNPI 1659656528

Title

Co-Founder/ President

Phone

(951) 521-0802

Specialties & licenses 1

Addresses

Other names 1

• Orange Tree Therapeutic Alliance / OTTA Therapy Doing business as

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Troy D Bradley, MSW,LCSW

  • Clinical Social Worker
  • Riverside, CA
  • NPI 1659656528
  NPD Authorized official

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

{
    "created_epoch": "1616112000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1616112000000",
    "number": "1144806258",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11801 PIERCE ST STE 200",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925054400",
            "telephone_number": "951-521-0802"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11801 PIERCE ST STE 200",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925054400",
            "telephone_number": "951-521-0802"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4392 6th St",
            "address_purpose": "LOCATION",
            "city": "Riverside",
            "state": "CA",
            "postal_code": "925012621",
            "country_code": "US",
            "telephone_number": "951-521-0802 x106",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "ORANGE TREE THERAPEUTIC ALLIANCE, A LCSW CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-03-19",
        "last_updated": "2021-03-19",
        "certification_date": "2021-03-18",
        "status": "A",
        "authorized_official_last_name": "BRADLEY",
        "authorized_official_first_name": "TROY",
        "authorized_official_middle_name": "DONAVON",
        "authorized_official_title_or_position": "CO-FOUNDER/ PRESIDENT",
        "authorized_official_telephone_number": "951-521-0802",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "II",
        "authorized_official_credential": "MSW, LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Orange Tree Therapeutic Alliance / OTTA Therapy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Clinical Social Worker in Riverside, CA
• Providers in Riverside, CA by specialty
• Clinical Social Worker in California

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