Bradley H Kennedy, MRC, CRC

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

111999 Issued in TX

Practice address

1905 Elder Hill Rd
Driftwood, TX 78619-2102

Phone

(281) 202-8672

NPI assigned

Nov 7, 2018

Last updated

Nov 7, 2018By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Obrc Operations, LLC

  dba Driftwood

  • Substance Abuse Rehabilitation Facility
  • Driftwood, TX
  • NPI 1124577440
  NPD (past)

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

{
    "created_epoch": "1541548800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1541548800000",
    "number": "1497223531",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1905 ELDER HILL RD",
            "city": "DRIFTWOOD",
            "state": "TX",
            "postal_code": "786192102",
            "telephone_number": "281-202-8672"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1905 ELDER HILL RD",
            "city": "DRIFTWOOD",
            "state": "TX",
            "postal_code": "786192102",
            "telephone_number": "281-202-8672"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENNEDY",
        "first_name": "BRADLEY",
        "middle_name": "H",
        "credential": "MRC, CRC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-11-07",
        "last_updated": "2018-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "TX",
            "license": "111999",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kathryn Monica Gomez-Flaming, RN, FNPC
• Michael Baker Hannah, M.S. L.P.C.
• Emily Rae Ilseng
• Imperial Med Services, LLC
• John T Conboy Inc
• Jenna Ashley Lawrence
• Steven Vincent Malone, P.T.
• Sable Nichole McArthur
• Jonathan Michael McPhee, FNP-BC
• Vedria E Millage, LCSW

• Addiction (Substance Use Disorder) Counselor in Driftwood, TX
• Providers in Driftwood, TX by specialty
• Addiction (Substance Use Disorder) Counselor in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2018; 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.