Kirsten Elizabeth Bradbury, PH.D.

Primary specialty

Clinical Child & Adolescent PsychologistTaxonomy code 103TC2200X

License

33639 Issued in TX

Practice address

3906 N Lamar Blvd
Suite 204-D
Austin, TX 78756-4025

Phone

(512) 745-6176

NPI assigned

Nov 14, 2007

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": "1194998400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1194998400000",
    "number": "1508047978",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3906 N LAMAR BLVD",
            "address_2": "SUITE 204-D",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787564025",
            "telephone_number": "512-745-6176"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3906 N LAMAR BLVD",
            "address_2": "SUITE 204-D",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787564025",
            "telephone_number": "512-745-6176"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRADBURY",
        "first_name": "KIRSTEN",
        "middle_name": "ELIZABETH",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-11-14",
        "last_updated": "2007-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "TX",
            "license": "33639",
            "primary": false
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "TX",
            "license": "33639",
            "primary": true
        },
        {
            "code": "103TH0004X",
            "taxonomy_group": "",
            "desc": "Psychologist, Health",
            "state": "TX",
            "license": "33639",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amber Len Brackmann, M.A. CCC-SLP
• Summer Brackmann, MS, RD, LD
• Cindy Kidd Brackmeyer, M.ED., LPC, RPT
• Brad E Logan
• Leah Manley Bradberry, CCC-SLP
• Sheila Dawn Bradbury, NNP
• Brooke Tooley Braddock, OT, MOT
• Braden Partners LP
• Valerie Braden, LCSW
• Trey Garrett Brader, M.D.

• Clinical Child & Adolescent Psychologist in Austin, TX
• Providers in Austin, TX by specialty
• Clinical Child & Adolescent Psychologist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2007; 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.