Active NPI
Jennifer Bradley, LGSW
- Social Worker
- Saint Paul, MN
National Provider Identifier
1396103545
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 21020
- Practice address
- 790 Cleveland Ave S
Suite 212
Saint Paul, MN 55116-3858 - Phone
- (612) 237-5243
- NPI assigned
- Feb 3, 2016
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Social Worker | 104100000X | 21020 | MN | Primary |
Addresses
Primary practice location
790 Cleveland Ave S
Suite 212
Saint Paul, MN 55116-3858
Mailing address
3816 25TH Ave S
Minneapolis, MN 55406-3010
Phone (612) 237-5243
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 |
|---|---|---|---|
| 21020 | MN | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1454457600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1454457600000",
"number": "1396103545",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3816 25TH AVE S",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "554063010",
"telephone_number": "612-237-5243"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "790 CLEVELAND AVE S",
"address_2": "SUITE 212",
"city": "SAINT PAUL",
"state": "MN",
"postal_code": "551163858",
"telephone_number": "612-237-5243"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRADLEY",
"first_name": "JENNIFER",
"credential": "LGSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-02-03",
"last_updated": "2016-02-03",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "MN",
"license": "21020",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Saint Paul, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.