Active NPI
Jennifer W. Bradford, PHD
- Psychologist
- Dallas, TX
National Provider Identifier
1306199245
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 36341
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 5
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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
| License | State | Type | Specialty |
|---|---|---|---|
| 35S100461900 | NJ | MD | Psychologist |
| 17357 | NY | MD | Psychologist |
| 36341 | TX | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Preston Hollow Health & Wellness, PLLC | Psychologist | Past | 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.
-
- Psychologist
- Dallas, TX
- NPI 1487183406
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2026; 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.