Individual provider Active NPI

Bradley Daniel Jump, LPC

  • Professional Counselor
  • Cambridge Springs, PA
National Provider Identifier
1629636857
Registry record updated Dec 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
PC011409 Issued in PA
Practice address
222 S Main St
Cambridge Springs, PA 16403-1140
Phone
(814) 573-0993
Fax
(833) 422-0143
NPI assigned
Jun 3, 2019
Last updated
Dec 2, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 2, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X PC011409 PA Primary

Addresses

Primary practice location

222 S Main St
Cambridge Springs, PA 16403-1140

Mailing address

222 S Main St
Cambridge Springs, PA 16403-1140
Phone (814) 573-0993

Medicare participation

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
PC011409PAMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Nicole L. Fies Professional PastSince Dec 8, 2024 Accepting new patients
Counseling Corner LLC Professional PastSince Dec 8, 2024 Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1559520000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733097600000",
    "number": "1629636857",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "222 S MAIN ST",
            "city": "CAMBRIDGE SPRINGS",
            "state": "PA",
            "postal_code": "164031140",
            "telephone_number": "814-573-0993"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "222 S MAIN ST",
            "city": "CAMBRIDGE SPRINGS",
            "state": "PA",
            "postal_code": "164031140",
            "telephone_number": "814-573-0993",
            "fax_number": "833-422-0143"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JUMP",
        "first_name": "BRADLEY",
        "middle_name": "DANIEL",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-06-03",
        "last_updated": "2024-12-02",
        "certification_date": "2024-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "PA",
            "license": "PC011409",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cambridge Springs, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2024; 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.