Individual provider Active NPI

Patricia Ann Bradshaw, LCMHC

  • Mental Health Counselor
  • Chapel Hill, NC
National Provider Identifier
1639346018
Registry record updated Mar 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
6951 Issued in NC
Practice address
1614 Orange Chapel Clover Garden Rd
Chapel Hill, NC 27516-7493
Phone
(919) 923-6671
NPI assigned
May 14, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 22, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 6951 NC Primary

Addresses

Primary practice location

1614 Orange Chapel Clover Garden Rd
Chapel Hill, NC 27516-7493

Mailing address

1614 Orange Chapel Clover Garden Rd
Chapel Hill, NC 27516-7493
Phone (919) 923-6671

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
6951NCMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1210723200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711065600000",
    "number": "1639346018",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1614 ORANGE CHAPEL CLOVER GARDEN RD",
            "city": "CHAPEL HILL",
            "state": "NC",
            "postal_code": "275167493",
            "telephone_number": "919-923-6671"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1614 ORANGE CHAPEL CLOVER GARDEN RD",
            "city": "CHAPEL HILL",
            "state": "NC",
            "postal_code": "275167493",
            "telephone_number": "919-923-6671"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRADSHAW",
        "first_name": "PATRICIA",
        "middle_name": "ANN",
        "name_prefix": "Ms.",
        "credential": "LCMHC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-05-14",
        "last_updated": "2024-03-22",
        "certification_date": "2024-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "6951",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chapel Hill, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 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.