Kevin Bradley, LCSW, P.C.

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

149009486 Issued in IL

Legal business name

KEVIN BRADLEY, LCSW, P.C.

Practice address

175 E Hawthorn Pkwy
336
Vernon Hills, IL 60061-1463

Phone

(847) 331-7907

NPI assigned

Apr 30, 2009

Organization subpart

No

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

Authorized official

Name

Mr. Kevin Bradley, L.C.S.W.NPI 1588683809

Title

President

Phone

(847) 331-7907

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kevin Bradley, L.C.S.W., PC

  • Clinical Social Worker
  • Vernon Hills, IL
  • NPI 1588683809
  Medicare reassignment NPD Authorized official
• Dena Jill Klapperich, PSY.D.

  • Clinical Psychologist
  • Vernon Hills, IL
  • NPI 1932295458
  NPD (past)

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

{
    "created_epoch": "1241049600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1241049600000",
    "number": "1497999783",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "175 E. HAWTHORN PARKWAY",
            "address_2": "336",
            "city": "VERNON HILLS",
            "state": "IL",
            "postal_code": "60061",
            "telephone_number": "847-331-7907"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "175 E HAWTHORN PKWY",
            "address_2": "336",
            "city": "VERNON HILLS",
            "state": "IL",
            "postal_code": "600611463",
            "telephone_number": "847-331-7907"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KEVIN BRADLEY, LCSW, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-04-30",
        "last_updated": "2009-04-30",
        "status": "A",
        "authorized_official_last_name": "BRADLEY",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "847-331-7907",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "L.C.S.W."
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149009486",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Margaret Kelly, RN
• Caitlin Ashley Kendler
• Kenneth a Holz DDS PC
• Ashley Heathere Kenniebrew, MSW
• Joan M Kessler, RN
• Rashima Khanna
• Neha Khemani, MD
• Ali Khoshkish, MD
• Dianna Katherine Kim, MD
• Rachel Kim

• Clinical Social Worker in Vernon Hills, IL
• Providers in Vernon Hills, IL by specialty
• Clinical Social Worker in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.