Bradley Warren Carson, MA
Individual provider Active NPI Social Worker · Marina, CA
NPI 1154845360 · NPPES record last updated Nov 16, 2018
Key facts
- NPI
- 1154845360
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Social Worker 104100000X
- Practice address
- 299 12TH St Ste a
Marina, CA 93933-6003 - Phone
- (831) 647-7652
- NPI assigned
- Jul 29, 2017
- Sex
- Male
- 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
- Credentials
- Master of Arts
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | |||
| Social Worker | 104100000X | Yes |
Addresses
Primary practice location
299 12TH St Ste a
Marina, CA 93933-6003
Mailing address
1196 Third Ave
Chula Vista, CA 91911-3131
Other providers in Marina, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 16, 2018. 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.