Robert Bradley, LPC

Individual provider Active NPI Mental Health Counselor · Maxwelton, WV

NPI 1154878346 · NPPES record last updated Jul 19, 2023

Key facts

NPI
1154878346
Entity type
Individual (NPI type 1)
Primary specialty
Mental Health Counselor 101YM0800X
License
2871 (WV)
Practice address
804 Industrial Park Rd
Maxwelton, WV 24957-8066
Phone
(304) 497-0500
NPI assigned
Sep 6, 2016
Sex
Male
Sole proprietor
Yes

Organizations & group practices 3

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

Medicare Care Compare profile

Specialty
Mental Health Counselor
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Seneca Health Services Inc (16 clinicians)

Practice addresses (Care Compare)

804 Industrial Park Rd
Maxwelton, WV 24957-8066
Phone (888) 736-3223

Medicare participation

Medicare fee-for-service enrollment
Enrolled in WV
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20240104000397 WV Practitioner - Mental Health Counselor 7214388263 Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD)
Yes

Practice roles

OrganizationSpecialtyStatusNew patients
Seneca Health Services, Inc. Current
since Jan 1, 2024
Accepting new patients
Seneca Health Services, Inc. Current
since Jan 1, 2024
Accepting new patients
Seneca Health Services Inc Community/Behavioral Health Past Accepting new patients

Locations

668 Church St
Lewisburg, WV 24901
Phone (304) 497-0500

704 3rd Ave
#A
Marlinton, WV 24954
Phone (304) 799-6865

704 3rd Ave
Marlinton, WV 24954
Phone (304) 799-6865

804 Industrial Park Rd
Ste 1
Maxwelton, WV 24957
Phone (304) 497-0500

804 Industrial Park Rd
Maxwelton, WV 24957
Phone (304) 497-0500

131 Wellness Dr
Summersville, WV 26651
Phone (304) 872-6503

180 Wellness Dr
Summersville, WV 26651
Phone (304) 872-0058

70 Parcoal Rd
Webster Springs, WV 26288
Phone (304) 847-5425

70 Parcoal Rd
#71
Webster Springs, WV 26288
Phone (304) 847-5425

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 2871 WV Yes

Addresses

Primary practice location

804 Industrial Park Rd
Maxwelton, WV 24957-8066

Mailing address

804 Industrial Park Rd
Maxwelton, WV 24957-8066
Phone (304) 497-0500

Other providers in Maxwelton, WV

All providers in Maxwelton, WV · Mental Health Counselor in West Virginia

Sources for this page

Verify at the official NPI Registry.