Stephanie Bradley, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

LPC008337 Issued in GA

Practice address

1025 Rose Creek Dr Ste 620-270
Woodstock, GA 30189-6797

Phone

(404) 907-3868

NPI assigned

Mar 3, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Jan 1, 2024 through Jan 1, 2028

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Anxiety Counseling Services of Ga LLC

  • Professional Counselor
  • Woodstock, GA
  • NPI 1073249777
  NPD Authorized official
• Hampton Newport News Community Services Board

  • Community/Behavioral Health Agency
  • Hampton, VA
  • NPI 1659424448
  NPD (past)

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

{
    "created_epoch": "1425340800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661558400000",
    "number": "1396137196",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1025 ROSE CREEK DR STE 620-270",
            "city": "WOODSTOCK",
            "state": "GA",
            "postal_code": "301896797",
            "telephone_number": "404-907-3868"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1025 ROSE CREEK DR STE 620-270",
            "city": "WOODSTOCK",
            "state": "GA",
            "postal_code": "301896797",
            "telephone_number": "404-907-3868"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "600 Medical Dr",
            "address_purpose": "LOCATION",
            "city": "Hampton",
            "state": "VA",
            "postal_code": "236661769",
            "country_code": "US",
            "telephone_number": "757-788-0300",
            "fax_number": "757-788-0969",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4255 Wade Green Rd NW Ste 414",
            "address_purpose": "LOCATION",
            "city": "Kennesaw",
            "state": "GA",
            "postal_code": "301441763",
            "country_code": "US",
            "telephone_number": "678-213-2194 x119",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BRADLEY",
        "first_name": "STEPHANIE",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-03-03",
        "last_updated": "2022-08-27",
        "certification_date": "2022-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "GA",
            "license": "LPC008337",
            "primary": true
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "VA",
            "license": "0701006054",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003170682A",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1659424448",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Brittany Bowman
• Kylie Jules Boyle, NP
• Angie S Bradley, PA-C
• Mallory Boehler Bradley, M.S., CCC-SLP
• Sedrick Bradley, M.D.
• Molly Teeling Bradshaw, RN
• Shannon Bragg
• Kristen Routzahn Braid, LCSW
• Brannan Chiropractic LLC
• Jillian Bredwell, MS, OTR/L

• Professional Counselor in Woodstock, GA
• Providers in Woodstock, GA by specialty
• Professional Counselor in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.