Lorin Leslie Bradbury, PH.D.
Individual provider Active NPI Clinical Psychologist · Bethel, AK
NPI 1649493552 · NPPES record last updated Sep 11, 2025
Key facts
- NPI
- 1649493552
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Psychologist 103TC0700X
- License
- 0390 (AK)
- Practice address
- 192 Alex Hately
Bethel, AK 99559 - Phone
- (907) 543-3266
- Fax
- (907) 543-4767
- NPI assigned
- Apr 10, 2007
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0390 | AK | MD | Clinical Psychologist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 0390 | AK | Yes |
| Forensic Psychologist | 103TF0200X | 0390 | AK |
Addresses
Primary practice location
192 Alex Hately
Bethel, AK 99559
Mailing address
PO Box 1748
Bethel, AK 99559-1748
Phone (907) 543-3266
Other providers in Bethel, AK
- Brain Boma
- Dolly Tracy Boney
- Pauline Boratko
- Robert K. Bornt
- Ronald Bowerman
- Tristan Bradley I
- Julia Bragg
- Ashley Brand
- Elwood J Brand
- Jody Lyn Brand
All providers in Bethel, AK · Clinical Psychologist in Alaska
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 11, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.