Bradley Kubat, MHC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

61195059 Issued in WA

Practice address

3917 N Monroe St
Spokane, WA 99205-9920

Phone

(509) 822-6777

NPI assigned

Feb 25, 2019

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Renegade Healing Co., LLC

  • Mental Health Counselor
  • Otis Orchards, WA
  • NPI 1780540864
  NPD Authorized official
• Foundations Family Support LLC

  • Mental Health Counselor
  • Spokane, WA
  • NPI 1083103238
  NPD (past)

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

{
    "created_epoch": "1551052800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629417600000",
    "number": "1255898441",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5012 N ELGIN ST",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992055644",
            "telephone_number": "253-617-8857"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3917 N MONROE ST",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992059920",
            "telephone_number": "509-822-6777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUBAT",
        "first_name": "BRADLEY",
        "credential": "MHC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-02-25",
        "last_updated": "2021-08-20",
        "certification_date": "2021-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WA",
            "license": "0000",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WA",
            "license": "61195059",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0000",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Duane August Kruschke II
• Caleb Kruse, PA-C
• Samantha Kruse, RN
• Madeleine Wade Krutz
• Jenn Renee Reylo Krzmarzick, LMHC
• Kathryn M Kubik, PA-C
• Roman Kudrya, DNAP
• Joshua Lee Kueber
• Reilly James Kuehn
• Kimberly Rose Kuehnel, B.A.

• Mental Health Counselor in Spokane, WA
• Providers in Spokane, WA by specialty
• Mental Health Counselor in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 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.