Active NPI
Briana E Bradshaw, MT3869
- Counselor
- Orlando, FL
National Provider Identifier
1679123400
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- License
- MT3869
- Practice address
- 12641 Newfield Dr
Orlando, FL 32837-7433 - Phone
- (321) 226-8882
- NPI assigned
- Sep 13, 2019
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | IMT2664 | FL | |
| Counselor | 101Y00000X | MT3869 | FL | Primary |
Addresses
Primary practice location
12641 Newfield Dr
Orlando, FL 32837-7433
Mailing address
12641 Newfield Dr
Orlando, FL 32837-7433
Phone (407) 432-6582
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
| License | State | Type | Specialty |
|---|---|---|---|
| MT3869 | FL | MD | Counselor |
| IMT2664 | FL | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1568332800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1637280000000",
"number": "1679123400",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12641 NEWFIELD DR",
"city": "ORLANDO",
"state": "FL",
"postal_code": "328377433",
"telephone_number": "407-432-6582"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12641 NEWFIELD DR",
"city": "ORLANDO",
"state": "FL",
"postal_code": "328377433",
"telephone_number": "321-226-8882"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRADSHAW",
"first_name": "BRIANA",
"middle_name": "E",
"credential": "MT3869",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-09-13",
"last_updated": "2021-11-19",
"certification_date": "2021-11-19",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "FL",
"license": "IMT2664",
"primary": false
},
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "FL",
"license": "MT3869",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Orlando, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.