Active NPI
Harry A. Bradley, PSYCHOLOGIST
- Clinical Psychologist
- Saint Louis, MO
National Provider Identifier
1205959806
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 00821
- Practice address
- 1275 N Berry Rd
Saint Louis, MO 63122-1920 - Phone
- (314) 644-1515
- Fax
- (314) 918-1384
- NPI assigned
- Apr 9, 2007
- Last updated
- Jul 8, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 00821 | MO | Primary |
Addresses
Primary practice location
1275 N Berry Rd
Saint Louis, MO 63122-1920
Mailing address
1275 N Berry Rd
Saint Louis, MO 63122-1920
Phone (314) 644-1515
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 00821 | MO | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1176076800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1205959806",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1275 N BERRY RD",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631221920",
"telephone_number": "314-644-1515",
"fax_number": "314-918-1384"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1275 N BERRY RD",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631221920",
"telephone_number": "314-644-1515",
"fax_number": "314-918-1384"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRADLEY",
"first_name": "HARRY",
"middle_name": "A.",
"name_prefix": "Mr.",
"credential": "PSYCHOLOGIST",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-04-09",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "MO",
"license": "00821",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Saint Louis, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.