Active NPI
Bradley Robert Kusick, MA LPC
- Professional Counselor
- Broomfield, CO
National Provider Identifier
1376767491
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 585
- Practice address
- 710 Burbank St Ste C
Broomfield, CO 80020-1658 - Phone
- (303) 907-3475
- NPI assigned
- Apr 12, 2007
- 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 |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 585 | CO | Primary |
Addresses
Primary practice location
710 Burbank St Ste C
Broomfield, CO 80020-1658
Mailing address
710 Burbank St Ste C
Broomfield, CO 80020-1658
Phone (303) 907-3475
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 86602560 | Medicaid | CO |
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
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 585 | CO | MD | Hearing Instrument Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1176336000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1231286400000",
"number": "1376767491",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "710 BURBANK ST STE C",
"city": "BROOMFIELD",
"state": "CO",
"postal_code": "800201658",
"telephone_number": "303-907-3475"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "710 BURBANK ST STE C",
"city": "BROOMFIELD",
"state": "CO",
"postal_code": "800201658",
"telephone_number": "303-907-3475"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KUSICK",
"first_name": "BRADLEY",
"middle_name": "ROBERT",
"name_prefix": "Mr.",
"credential": "MA LPC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-04-12",
"last_updated": "2009-01-07",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "CO",
"license": "585",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "86602560",
"state": "CO"
}
],
"endpoints": [],
"other_names": []
}Other providers in Broomfield, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.