Individual provider Active NPI

William Bradley

  • Clinical Social Worker
  • Austin, TX
National Provider Identifier
1265782841
Registry record updated Dec 13, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
64883 Issued in TX
Practice address
1430 Collier St
Austin, TX 78704-2911
Phone
(512) 472-4357
Fax
(512) 703-1394
NPI assigned
Sep 11, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 13, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 64883 TX
Clinical Social Worker 1041C0700X 64883 TX Primary

Addresses

Primary practice location

1430 Collier St
Austin, TX 78704-2911

Mailing address

1430 Collier St
Austin, TX 78704-2911
Phone (512) 472-4357

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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

Enrollment IDStateProvider typePAC IDDetails
I20220222000032 TX Practitioner - Clinical Social Worker 1850785676 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Austin Travis County Mental Health and Mental Retardation Center Social Worker CurrentSince Dec 16, 2021 Accepting new patients
Austin Travis County Mental Health and Mental Retardation Center CurrentSince Dec 16, 2021 Accepting new patients

Locations

1430 Collier St
Austin, TX 78704
Phone (512) 427-4357

1165 Airport Blvd
Austin, TX 78702
Phone (512) 703-1312

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1347321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639353600000",
    "number": "1265782841",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1430 COLLIER ST",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787042911",
            "telephone_number": "512-472-4357",
            "fax_number": "512-703-1394"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1430 COLLIER ST",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787042911",
            "telephone_number": "512-472-4357",
            "fax_number": "512-703-1394"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRADLEY",
        "first_name": "WILLIAM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-09-11",
        "last_updated": "2021-12-13",
        "certification_date": "2021-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "TX",
            "license": "64883",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "64883",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Austin, TX

Sources for this page

Verify at the official NPI Registry.