Active NPI
Kathleen Bradford, LCPC
- Professional Counselor
- Missoula, MT
National Provider Identifier
1275711301
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 1316
- Practice address
- 1515 Fairview Ave
Ste. 235
Missoula, MT 59801-0235 - Phone
- (406) 721-5157
- Fax
- (406) 327-1215
- NPI assigned
- Jan 31, 2008
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 1316 | MT | Primary |
Addresses
Primary practice location
1515 Fairview Ave
Ste. 235
Missoula, MT 59801-0235
Mailing address
1515 Fairview Ave.
Ste. 235
Missoula, MT 59801-0235
Phone (406) 721-5157
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1316 | Other | MT | STATE LICENSE |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1316 | MT | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1201737600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1201737600000",
"number": "1275711301",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1515 FAIRVIEW AVE.",
"address_2": "STE. 235",
"city": "MISSOULA",
"state": "MT",
"postal_code": "598010235",
"telephone_number": "406-721-5157",
"fax_number": "406-327-1215"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1515 FAIRVIEW AVE",
"address_2": "STE. 235",
"city": "MISSOULA",
"state": "MT",
"postal_code": "598010235",
"telephone_number": "406-721-5157",
"fax_number": "406-327-1215"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRADFORD",
"first_name": "KATHLEEN",
"credential": "LCPC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-01-31",
"last_updated": "2008-01-31",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "MT",
"license": "1316",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE LICENSE",
"identifier": "1316",
"state": "MT"
}
],
"endpoints": [],
"other_names": []
}Other providers in Missoula, MT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.