Mikaela Bradley, CGC

Primary specialty

Genetic Counselor (M.S.)Taxonomy code 170300000X

License

7201000566 Issued in MI

Practice address

3577 W 13 Mile Rd Ste 140
Royal Oak, MI 48073-6710

Phone

(248) 551-3384

NPI assigned

May 14, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Creating Brighter Futures

  • Speech-Language Pathologist
  • Ann Arbor, MI
  • NPI 1891411542
  NPD (past)
• Creating Brighter Futures, Inc

  • Behavior Analyst
  • Ann Arbor, MI
  • NPI 1881939346
  NPD (past)

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

{
    "created_epoch": "1557792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728000000000",
    "number": "1356907463",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3577 W 13 MILE RD STE 140",
            "city": "ROYAL OAK",
            "state": "MI",
            "postal_code": "480736710",
            "telephone_number": "248-551-3384"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3577 W 13 MILE RD STE 140",
            "city": "ROYAL OAK",
            "state": "MI",
            "postal_code": "480736710",
            "telephone_number": "248-551-3384"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRADLEY",
        "first_name": "MIKAELA",
        "credential": "CGC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-05-14",
        "last_updated": "2024-10-04",
        "certification_date": "2024-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "170300000X",
            "taxonomy_group": "",
            "desc": "Genetic Counselor, MS",
            "state": "MI",
            "license": "7201000566",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mbradley2751535@epic00.corewelldirect.org",
            "affiliation": "N",
            "address_1": "3577 W 13 Mile Rd Ste 140",
            "city": "Royal Oak",
            "state": "MI",
            "country_code": "US",
            "postal_code": "480736710",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Donald Brabbins
• Katharine E Brace, LMSW
• Olivia Jane Brack
• Olivia Bradin
• Anthony Bradley
• Nicole Bradway
• Pavan Brahmamdam, MD
• Alyssa Brandenburg, OTR/L
• Shawn Brandenburg, M.D.
• Nathan James Branson, PA-C

• All providers in Royal Oak, MI
• Genetic Counselor (M.S.) in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2024; 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.