Bradley Thomas Mayville

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

36560 Issued in NY

Practice address

1519 Nye Rd
Lyons, NY 14489-9133

Phone

(315) 946-5722

Fax

(315) 946-7048

NPI assigned

Jan 15, 2021

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1610668800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610668800000",
    "number": "1215526066",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1519 NYE RD",
            "city": "LYONS",
            "state": "NY",
            "postal_code": "144899133",
            "telephone_number": "315-946-5722"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1519 NYE RD",
            "city": "LYONS",
            "state": "NY",
            "postal_code": "144899133",
            "telephone_number": "315-946-5722",
            "fax_number": "315-946-7048"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAYVILLE",
        "first_name": "BRADLEY",
        "middle_name": "THOMAS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-01-15",
        "last_updated": "2021-01-15",
        "certification_date": "2021-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NY",
            "license": "36560",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Wilber Mahar Jr., LPN
• Teresa Mailoli
• Patrick M Maney, MSW
• Lynne Marie Maslyn, R.N.
• Joseph D Mattes, MSW
• Kimberly F McCaffrey, M.A.
• Samantha McElligott, CASAC-T
• Marshall Philip McFarland, LMSW
• Patricia Marie McKinny, LICENSED MENTAL HEAL
• Quiana McMillan, LPN

• Addiction (Substance Use Disorder) Counselor in Lyons, NY
• Providers in Lyons, NY by specialty
• Addiction (Substance Use Disorder) Counselor in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 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.