Active NPI
Bradley Gifford, LCDC III
- Counselor
- Hamilton, OH
National Provider Identifier
1336679471
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- License
- LCDC141099-3
- Practice address
- 820 S Martin Luther King Jr Blvd
Hamilton, OH 45011-3216 - Phone
- (513) 887-8500
- Fax
- (513) 737-8196
- NPI assigned
- Jun 12, 2017
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Counselor | 101Y00000X | LCDC141099-3 | OH | Primary |
Addresses
Primary practice location
820 S Martin Luther King Jr Blvd
Hamilton, OH 45011-3216
Mailing address
820 S Martin Luther King Jr Blvd
Hamilton, OH 45011-3216
Phone (513) 887-8500
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 |
|---|---|---|---|
| LCDC141099-3 | OH | MD | Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kav Health Group LLC | 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.
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Dayton, OH
- NPI 1891332946
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1497225600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658361600000",
"number": "1336679471",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "820 S MARTIN LUTHER KING JR BLVD",
"city": "HAMILTON",
"state": "OH",
"postal_code": "450113216",
"telephone_number": "513-887-8500",
"fax_number": "513-737-8196"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "820 S MARTIN LUTHER KING JR BLVD",
"city": "HAMILTON",
"state": "OH",
"postal_code": "450113216",
"telephone_number": "513-887-8500",
"fax_number": "513-737-8196"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GIFFORD",
"first_name": "BRADLEY",
"credential": "LCDC III",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-06-12",
"last_updated": "2022-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "OH",
"license": "LCDC141099-3",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hamilton, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.