Kyana Bradley, LPC, LCPC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

LC8316 Issued in MD

Practice address

8101 Sandy Spring Rd Ste 250
Laurel, MD 20707-3527

Phone

(202) 344-7933

Fax

(240) 366-5750

NPI assigned

May 7, 2018

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 6

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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 and National Provider Directory roles.

• Authentic Connections Therapeutic Services

  • Mental Health Counselor
  • Laurel, MD
  • NPI 1205302585
  NPD Authorized official

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

{
    "created_epoch": "1525651200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560211200000",
    "number": "1578052486",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "909 4TH ST APT D",
            "city": "LAUREL",
            "state": "MD",
            "postal_code": "207075121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8101 SANDY SPRING RD STE 250",
            "city": "LAUREL",
            "state": "MD",
            "postal_code": "207073527",
            "telephone_number": "202-344-7933",
            "fax_number": "240-366-5750"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9500 Arena Dr",
            "address_purpose": "LOCATION",
            "city": "Upper Marlboro",
            "state": "MD",
            "postal_code": "207743701",
            "country_code": "US",
            "telephone_number": "301-323-8256",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BRADLEY",
        "first_name": "KYANA",
        "credential": "LPC, LCPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-05-07",
        "last_updated": "2019-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor",
            "state": "MD",
            "license": "LC8316",
            "primary": false
        },
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "DC",
            "license": "PRC14889",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "DC",
            "license": "PRC14889",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MD",
            "license": "LC8316",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "DC",
            "license": "PRC14889",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MD",
            "license": "LC8316",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "907084200",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Caroline Boutros
• Shelia Stephanie Bowe-Connor, RPH
• Brianna Boyd
• Dedrie Boykin, LCSW-C
• Willine A Boyo, PHARM D
• Jeffrey Henry Brain, DDS
• Joseph Francis Branda, MD
• Edna Marie Brandt, L.AC.
• Marie A. Brantley, RNCS
• Austin Breglia, DDS

• Mental Health Counselor in Laurel, MD
• Providers in Laurel, MD by specialty
• Mental Health Counselor in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2019; 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.