Michelle Bradham-Cousar, PHD, CRC, LMHC, NCC

Primary specialty

Rehabilitation CounselorTaxonomy code 225C00000X

License

00102595 Issued in FL

Practice address

1503 S US 301 Unit 92
Tampa, FL 33619

Phone

(941) 250-5446

NPI assigned

Feb 11, 2022

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1644537600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644537600000",
    "number": "1417601097",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10121 E ADAMO DR UNIT 89761",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336899038"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1503 S US 301 UNIT 92",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "33619",
            "telephone_number": "941-250-5446"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRADHAM-COUSAR",
        "first_name": "MICHELLE",
        "name_prefix": "Dr.",
        "credential": "PHD, CRC, LMHC, NCC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-02-11",
        "last_updated": "2022-02-11",
        "certification_date": "2022-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": null,
            "primary": false
        },
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": "FL",
            "license": null,
            "primary": false
        },
        {
            "code": "225C00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Rehabilitation Counselor",
            "state": "FL",
            "license": "00102595",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Connor Lee Bracy
• Robert P Bradbury, RPH
• Courtney Sandra Braden, LMT
• Phuong Diep Bradford, APRN
• Shelica Anastari Bradford, PA-C
• Bradley D Fouraker MD LLC
• Alayna Nicole Bradley, PA
• Allison Bradley
• Anthony Bradley, M.D.
• Chandler Rose Marie Bradley

• Rehabilitation Counselor in Tampa, FL
• Providers in Tampa, FL by specialty
• Rehabilitation Counselor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 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.

Verify at the official NPI Registry.