Bradford Holl, LPC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

809 Issued in AK

Practice address

1261 S Seward Meridian Pkwy
Wasilla, AK 99654-8372

Phone

(907) 351-9220

Fax

(907) 373-9220

NPI assigned

Dec 10, 2013

Sex

Male

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Lighted Path Therapy Services

  • Professional Counselor
  • Wasilla, AK
  • NPI 1093212466
  NPD Authorized official

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

{
    "created_epoch": "1386633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1386633600000",
    "number": "1306277702",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 67",
            "city": "PALMER",
            "state": "AK",
            "postal_code": "996450067",
            "telephone_number": "907-351-9220",
            "fax_number": "907-373-9220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1261 S SEWARD MERIDIAN PKWY",
            "city": "WASILLA",
            "state": "AK",
            "postal_code": "996548372",
            "telephone_number": "907-351-9220",
            "fax_number": "907-373-9220"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLL",
        "first_name": "BRADFORD",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-12-10",
        "last_updated": "2013-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "AK",
            "license": "809",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kara Jane Holbrook, LPN
• Mary K Holbrook
• Stephanie Ann Holcomb
• James Winfield Holen, M.A., LPC
• Alice Jean Holinger, PT
• Vanessa Holm
• Lacy Jay Holmes
• Stephen Holmstock
• Home Health LLC
• Hayley Charisma Hooks

• Mental Health Counselor in Wasilla, AK
• Providers in Wasilla, AK by specialty
• Mental Health Counselor in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.