Individual provider Active NPI

Bradie Harbison, M.ED, LCDC, LPC

  • Professional Counselor
  • Round Rock, TX
National Provider Identifier
1265014419
Registry record updated Apr 27, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
81007 Issued in TX
Practice address
650 Louis Henna Blvd Apt 7306
Round Rock, TX 78664-7561
Phone
(512) 508-3229
NPI assigned
Apr 27, 2021
Last updated
Apr 27, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 27, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 15045 TX
Professional CounselorGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 101YP2500X 81007 TX Primary

Addresses

Primary practice location

650 Louis Henna Blvd Apt 7306
Round Rock, TX 78664-7561

Mailing address

650 Louis Henna Blvd Apt 7306
Round Rock, TX 78664-7561
Phone (512) 508-3229

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
Credentials
Master of Education

State licenses

LicenseStateTypeSpecialty
81007TXMDProfessional Counselor
15045TXMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1619481600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619481600000",
    "number": "1265014419",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "650 LOUIS HENNA BLVD APT 7306",
            "city": "ROUND ROCK",
            "state": "TX",
            "postal_code": "786647561",
            "telephone_number": "512-508-3229"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "650 LOUIS HENNA BLVD APT 7306",
            "city": "ROUND ROCK",
            "state": "TX",
            "postal_code": "786647561",
            "telephone_number": "512-508-3229"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARBISON",
        "first_name": "BRADIE",
        "credential": "M.ED, LCDC, LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-04-27",
        "last_updated": "2021-04-27",
        "certification_date": "2021-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "TX",
            "license": "15045",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "81007",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Round Rock, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 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.