Individual provider Active NPI

Christina Hayes-Bradham, LPC

  • Professional Counselor
  • North Charleston, SC
National Provider Identifier
1740684281
Registry record updated Oct 13, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
5543 Issued in SC
Practice address
104 Broadmarsh CT
North Charleston, SC 29418-3054
Phone
(843) 696-1967
Fax
(843) 552-3613
NPI assigned
Oct 13, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 13, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 5543 SC Primary

Addresses

Primary practice location

104 Broadmarsh CT
North Charleston, SC 29418-3054

Mailing address

104 Broadmarsh CT
North Charleston, SC 29418-3054
Phone (843) 696-1967

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240102002352 SC Practitioner - Mental Health Counselor 4688024748

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5543SCMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Thrive Counseling LLC CurrentSince Jan 1, 2024 Accepting new patients

Locations

4975 Lacross Rd
Ste 351
North Charleston, SC 29406
Phone (800) 309-1159

1000 Jefferson St
Ste 2C
Lynchburg, VA 24504
Phone (434) 528-3263

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1413158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1413158400000",
    "number": "1740684281",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 BROADMARSH CT",
            "city": "NORTH CHARLESTON",
            "state": "SC",
            "postal_code": "294183054",
            "telephone_number": "843-696-1967",
            "fax_number": "843-552-3613"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 BROADMARSH CT",
            "city": "NORTH CHARLESTON",
            "state": "SC",
            "postal_code": "294183054",
            "telephone_number": "843-696-1967",
            "fax_number": "843-552-3613"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAYES-BRADHAM",
        "first_name": "CHRISTINA",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-10-13",
        "last_updated": "2014-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "SC",
            "license": "5543",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Charleston, SC

Sources for this page

Verify at the official NPI Registry.