Kevin E Bradt, LADC

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

303830 Issued in MN

Practice address

2680 Snelling Ave N Ste 200
Roseville, MN 55113-1879

Phone

(651) 364-9381

NPI assigned

Feb 11, 2022

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1644537600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644537600000",
    "number": "1639823230",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1171 BROOKS AVE W",
            "city": "ROSEVILLE",
            "state": "MN",
            "postal_code": "551133202",
            "telephone_number": "612-804-8602"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2680 SNELLING AVE N STE 200",
            "city": "ROSEVILLE",
            "state": "MN",
            "postal_code": "551131879",
            "telephone_number": "651-364-9381"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRADT",
        "first_name": "KEVIN",
        "middle_name": "E",
        "credential": "LADC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-02-11",
        "last_updated": "2022-02-11",
        "certification_date": "2022-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "MN",
            "license": "303830",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Angela Boston
• BPK Professionals, LLC
• Jeffrey Rex Brace, M.D.
• Jessica Lynn Bracken, BCBA
• Carissa Kay Bradley
• Brian Bradway, PA-C
• Brain Injury Association of Minnesota
• Braincare, LLC
• Michael Anthony Branchaud, LPC
• Breakthrough Medical Supply Inc

• Addiction (Substance Use Disorder) Counselor in Roseville, MN
• Providers in Roseville, MN by specialty
• Addiction (Substance Use Disorder) Counselor in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2022; 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.