Sylvia Kirkendall Bradley, LPTA

Individual provider Active NPI Speech-Language Pathologist · Dunn, NC

NPI 1598877334 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1598877334
Entity type
Individual (NPI type 1)
Primary specialty
Speech-Language Pathologist 235Z00000X
License
1016 (NC)
Practice address
1100 S Clinton Avenue
Suite C
Dunn, NC 28334
Phone
(910) 892-0027
Fax
(910) 892-0029
NPI assigned
Aug 31, 2006
Sex
Female
Sole proprietor
No

Organizations & group practices 1

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.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
1016NCMDAddiction (Substance Use Disorder) Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Carolina Therapy Services Inc Speech-Language Pathologist Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 1016 NC Yes

Addresses

Primary practice location

1100 S Clinton Avenue
Suite C
Dunn, NC 28334

Mailing address

1100 S Clinton Avenue
Suite C
Dunn, NC 28334
Phone (910) 892-0027

Other identifiers

IdentifierTypeStateIssuer
721634MedicaidNC

Other providers in Dunn, NC

All providers in Dunn, NC · Speech-Language Pathologist in North Carolina

Sources for this page

Verify at the official NPI Registry.