Martha Bradley, LMHC
Individual provider Active NPI Mental Health Counselor · Bunnell, FL
NPI 1235780776 · NPPES record last updated Nov 8, 2024
Key facts
- NPI
- 1235780776
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Mental Health Counselor 101YM0800X
- License
- MH24395 (FL)
- Practice address
- 301 Justice LN
Bunnell, FL 32110-4487 - Phone
- (800) 539-4228
- NPI assigned
- Sep 26, 2019
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| APC6784 | GA | MD | Mental Health Counselor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | APC6784 | GA | |
| Mental Health Counselor | 101YM0800X | MH24395 | FL | Yes |
Addresses
Primary practice location
301 Justice LN
Bunnell, FL 32110-4487
Mailing address
150 Magnolia Ave
Daytona Beach, FL 32114-4304
Phone (386) 236-3225
Other practice location 1
1220 Willis Ave
Daytona Beach, FL 32114-2810
Phone (800) 539-4228
Other providers in Bunnell, FL
- Frances Elizabeth Bey
- Stephen R. Bickel
- Kristina H Blanchek
- Andrew Bliss
- Ronda Maria Bostick
- Mary Anna Buckner
- Bunnell Medical Center Inc
- Bunnell Pharmacy Inc
- Carlisi Chiropractic Center Inc.
- Roy Carlisi
All providers in Bunnell, FL · Mental Health Counselor in Florida
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 8, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.