Active NPI
Laurie Bradley, LMHC
- Mental Health Counselor
- Gainesville, FL
National Provider Identifier
1750568994
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- MH6022
- Practice address
- 901 NW 8TH Ave
Suite C311
Gainesville, FL 32601-5011 - Phone
- (352) 264-8152
- NPI assigned
- Jan 30, 2008
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | MH6022 | FL | Primary |
Addresses
Primary practice location
901 NW 8TH Ave
Suite C311
Gainesville, FL 32601-5011
Mailing address
901 NW 8TH Ave
Suite C311
Gainesville, FL 32601-5011
Phone (352) 264-8152
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| MH6022 | Other | FL | PROFESSIONAL LICENSE |
| 762061600 | Medicaid | FL |
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 |
|---|---|---|---|
| MH6022 | FL | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1201651200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1201651200000",
"number": "1750568994",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "901 NW 8TH AVE",
"address_2": "SUITE C311",
"city": "GAINESVILLE",
"state": "FL",
"postal_code": "326015011",
"telephone_number": "352-264-8152"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "901 NW 8TH AVE",
"address_2": "SUITE C311",
"city": "GAINESVILLE",
"state": "FL",
"postal_code": "326015011",
"telephone_number": "352-264-8152"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRADLEY",
"first_name": "LAURIE",
"name_prefix": "Ms.",
"credential": "LMHC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-01-30",
"last_updated": "2008-01-30",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "FL",
"license": "MH6022",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PROFESSIONAL LICENSE",
"identifier": "MH6022",
"state": "FL"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "762061600",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Gainesville, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.