Active NPI
Kesha L Bradford, MSW, LGSW
- Professional Counselor
- Minneapolis, MN
National Provider Identifier
1235746579
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 29289
- Practice address
- 4315 Irving Ave N
Minneapolis, MN 55412-1258 - Phone
- (612) 703-2618
- NPI assigned
- Sep 30, 2020
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 29289 | MN | Primary |
Addresses
Primary practice location
4315 Irving Ave N
Minneapolis, MN 55412-1258
Mailing address
4315 Irving Ave N
Minneapolis, MN 55412-1258
Phone (612) 703-2618
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1780014522 | Medicaid | WA |
Electronic endpoints 2
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Other URL | Minneapolis | Direct | EMC2 Educational Consulting, LLC |
| CONNECT URL | www.onyxtherapygroup.com | Direct |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1601424000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1701043200000",
"number": "1235746579",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4315 IRVING AVE N",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "554121258",
"telephone_number": "612-703-2618"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4315 IRVING AVE N",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "554121258",
"telephone_number": "612-703-2618"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRADFORD",
"first_name": "KESHA",
"middle_name": "L",
"credential": "MSW, LGSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-09-30",
"last_updated": "2023-11-27",
"certification_date": "2020-09-30",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "MN",
"license": "29289",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1780014522",
"state": "WA"
}
],
"endpoints": [
{
"endpointType": "OTHERS",
"endpointTypeDescription": "Other URL",
"endpoint": "Minneapolis",
"affiliation": "Y",
"endpointDescription": "Home",
"affiliationName": "EMC2 Educational Consulting, LLC",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "Minneapolis",
"address_1": "1420 Columbia Rd NW",
"city": "Washington",
"state": "DC",
"country_code": "US",
"postal_code": "200094779",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "www.onyxtherapygroup.com",
"affiliation": "N",
"endpointDescription": "Wensite",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "1420 Columbia Rd NW",
"city": "Washington",
"state": "DC",
"country_code": "US",
"postal_code": "200094779",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Minneapolis, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.