Individual provider Active NPI

Jennifer W. Bradford, PHD

  • Psychologist
  • Dallas, TX
National Provider Identifier
1306199245
Registry record updated Jul 7, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
36341 Issued in TX
Practice address
8140 Walnut Hall Lane
Suite 320
Dallas, TX 75231
Phone
(972) 863-2232
Fax
(972) 474-9043
NPI assigned
Oct 16, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 7, 2026

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 35S100461900 NJ
Professional Counselor 101YP2500X 17483
Counseling Psychologist 103TC1900X 21637 CA
Psychologist 103T00000X 17357 NY
Psychologist 103T00000X 36341 TX Primary

Addresses

Primary practice location

8140 Walnut Hall Lane
Suite 320
Dallas, TX 75231

Mailing address

8140 Walnut Hill LN Ste 320
Dallas, TX 75231-4328
Phone (972) 863-2232

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
I20241106002794 TX Practitioner - Clinical Psychologist 5294015863 Practice locations: Dallas, TX

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
35S100461900NJMDPsychologist
17357NYMDPsychologist
36341TXMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Preston Hollow Health & Wellness, PLLC Psychologist PastSince Jul 24, 2022 Accepting new patients

Organizations & group practices 1

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": "1350345600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783382400000",
    "number": "1306199245",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8140 WALNUT HILL LN STE 320",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752314328",
            "telephone_number": "972-863-2232",
            "fax_number": "972-474-9043"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8140 WALNUT HALL LANE",
            "address_2": "SUITE 320",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "75231",
            "telephone_number": "972-863-2232",
            "fax_number": "972-474-9043"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRADFORD",
        "first_name": "JENNIFER",
        "middle_name": "W.",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-10-16",
        "last_updated": "2026-07-07",
        "certification_date": "2026-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NJ",
            "license": "35S100461900",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": null,
            "license": "17483",
            "primary": false
        },
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "CA",
            "license": "21637",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NY",
            "license": "17357",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "TX",
            "license": "36341",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.