Organization Active NPI

Jill Bradley LCSW LLC

  • Clinical Social Worker
  • Colorado Springs, CO
National Provider Identifier
1629936620
Registry record updated Jan 10, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
JILL BRADLEY LCSW LLC
Practice address
4740 Flintridge Dr Ste 220L
Colorado Springs, CO 80918-4273
Phone
(719) 459-9037
Fax
(719) 428-4592
NPI assigned
Jan 10, 2026
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 10, 2026

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

Authorized official

Name
Jill Michelle Bradley, LCSWNPI 1316262371
Title
Licensed Clinical Social Worker
Phone
(719) 459-9034

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X Primary

Addresses

Primary practice location

4740 Flintridge Dr Ste 220L
Colorado Springs, CO 80918-4273

Mailing address

4740 Flintridge Dr Ste 220L
Colorado Springs, CO 80918-4273
Phone (719) 459-9034

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20260310004820 CO Part B Supplier - Clinic/Group Practice 5799268553 Receives reassigned benefits from 1 practitioner
Practice locations: Colorado Springs, CO

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1768003200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1768003200000",
    "number": "1629936620",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4740 FLINTRIDGE DR STE 220L",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809184273",
            "telephone_number": "719-459-9034",
            "fax_number": "719-428-4592"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4740 FLINTRIDGE DR STE 220L",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809184273",
            "telephone_number": "719-459-9037",
            "fax_number": "719-428-4592"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JILL BRADLEY LCSW LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-01-10",
        "last_updated": "2026-01-10",
        "certification_date": "2026-01-10",
        "status": "A",
        "authorized_official_last_name": "BRADLEY",
        "authorized_official_first_name": "JILL",
        "authorized_official_middle_name": "MICHELLE",
        "authorized_official_title_or_position": "LICENSED CLINICAL SOCIAL WORKER",
        "authorized_official_telephone_number": "719-459-9034",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Colorado Springs, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2026; 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.