Individual provider Active NPI

Bradlee Raphiel Vasquez-Valdez

  • Social Worker
  • Cleveland, OH
National Provider Identifier
1336623552
Registry record updated Sep 24, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
1800471 Issued in OH
Practice address
3518 W 25TH St
Cleveland, OH 44109-1951
Phone
(216) 741-2241
NPI assigned
Sep 24, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 24, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 1800471 OH Primary

Addresses

Primary practice location

3518 W 25TH St
Cleveland, OH 44109-1951

Mailing address

3164 Meadowbrook Blvd FL 2
Cleveland Heights, OH 44118-2802
Phone (914) 267-4594

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

LicenseStateTypeSpecialty
1800471OHMDSocial Worker

NPI Registry JSON

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

{
    "created_epoch": "1537747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1537747200000",
    "number": "1336623552",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3164 MEADOWBROOK BLVD FL 2",
            "city": "CLEVELAND HEIGHTS",
            "state": "OH",
            "postal_code": "441182802",
            "telephone_number": "914-267-4594"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3518 W 25TH ST",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441091951",
            "telephone_number": "216-741-2241"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VASQUEZ-VALDEZ",
        "first_name": "BRADLEE",
        "middle_name": "RAPHIEL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-09-24",
        "last_updated": "2018-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "OH",
            "license": "1800471",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cleveland, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2018; 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.