Cory Lea Bradley

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LMSW-43072 Issued in ID

Practice address

992 W Idaho Ave
Ontario, OR 97914-2111

Phone

(208) 405-0020

Fax

(208) 739-4425

NPI assigned

Aug 23, 2021

Last updated

May 13, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Practice roles

Locations

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

• Morgan Mental Health Group LLC

  • Mental Health Counselor
  • Meridian, ID
  • NPI 1457993230

  Clinical

  NPD
• Access Behavioral Health Services, Inc

  • Intellectual and/or Developmental Disabilities Residential Treatment Facility
  • Boise, ID
  • NPI 1962018564
  NPD (past)
• Insight Counseling & Therapy

  • Clinical Social Worker
  • Payette, ID
  • NPI 1104350511
  NPD (past)
• Insight Matters, Inc

  • Mental Health Counselor
  • Payette, ID
  • NPI 1487350641
  NPD (past)

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

{
    "created_epoch": "1629676800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683936000000",
    "number": "1821764499",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1901 N LAKES PL",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836465939",
            "telephone_number": "208-890-7165",
            "fax_number": "208-739-4425"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "992 W IDAHO AVE",
            "city": "ONTARIO",
            "state": "OR",
            "postal_code": "979142111",
            "telephone_number": "208-405-0020",
            "fax_number": "208-739-4425"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRADLEY",
        "first_name": "CORY",
        "middle_name": "LEA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-23",
        "last_updated": "2023-05-13",
        "certification_date": "2023-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ID",
            "license": "LMSW-43072",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kathleen Bosler, RN
• Victoria Lee Bounds, QMHA
• Sabrina Catherine Bourasa
• Joseph Boyle, MD
• Kendra E Brabb
• Deanna Lorraine Branscomb, BA
• David W. Brauer, MD
• Kimberly Jeanne Brechbiel
• Bradie Brodhecker
• Heather Roberta Brown

• Clinical Social Worker in Ontario, OR
• Providers in Ontario, OR by specialty
• Clinical Social Worker in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2023; 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.