Callie Jo Bradford, LPCC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

295709 Issued in KY

Practice address

404 Public SQ
Columbia, KY 42728-1458

Phone

(270) 634-9346

NPI assigned

Oct 3, 2022

Last updated

Jan 10, 2025By the provider in NPPES

Sex

Female

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

Enrolled in KY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Breath of Grace Wellness

  • Professional Counselor
  • Columbia, KY
  • NPI 1003550575
  Medicare reassignment NPD

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

{
    "created_epoch": "1664755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736467200000",
    "number": "1265156285",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "404 PUBLIC SQ",
            "city": "COLUMBIA",
            "state": "KY",
            "postal_code": "427281458",
            "telephone_number": "270-634-9346"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "404 PUBLIC SQ",
            "city": "COLUMBIA",
            "state": "KY",
            "postal_code": "427281458",
            "telephone_number": "270-634-9346"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRADFORD",
        "first_name": "CALLIE",
        "middle_name": "JO",
        "credential": "LPCC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-10-03",
        "last_updated": "2025-01-10",
        "certification_date": "2025-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "KY",
            "license": "295709",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer R Blair, LPCC
• Nicholas Wayne Bloodworth, LMFT
• Kayla Bodner
• Kendra R Bolom, RBT
• David Earl Bowman, RPH
• Leticia Nichole Branham
• Julie A Brawner, LCSW
• Breath of Grace Wellness
• Chad Brown
• Irma Leticia Brown, MSN, PMHNP-BC

• Professional Counselor in Columbia, KY
• Providers in Columbia, KY by specialty
• Professional Counselor in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.