Jada Crystal Bradberry, LMSW

Primary specialty

Social WorkerTaxonomy code 104100000X

License

109643 Issued in NY

Practice address

398 N Walnut St
East Orange, NJ 07017-3917

Phone

(862) 591-7747

NPI assigned

Jul 11, 2020

Last updated

Jul 11, 2020By 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

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

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.

• Senior Care Therapy LLC

  • Clinical Psychologist
  • Passaic, NJ
  • NPI 1285898098
  NPD

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

{
    "created_epoch": "1594425600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594425600000",
    "number": "1841818226",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "398 N WALNUT ST",
            "city": "EAST ORANGE",
            "state": "NJ",
            "postal_code": "070173917",
            "telephone_number": "862-591-7747"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "398 N WALNUT ST",
            "city": "EAST ORANGE",
            "state": "NJ",
            "postal_code": "070173917",
            "telephone_number": "862-591-7747"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRADBERRY",
        "first_name": "JADA",
        "middle_name": "CRYSTAL",
        "name_prefix": "Ms.",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-07-11",
        "last_updated": "2020-07-11",
        "certification_date": "2020-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "109643",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Suzanne W Botrous, M.D.
• Joachim S Bottoms
• Vanessa Verlinger Boucher, MSED
• Jessica Bowen
• Ramonita Bracy
• Bella Bradford
• Ayanna Celeste Bradshaw-Sydnor, D.D.S.
• Sasha Branch, LCADC
• Sonia A Bratcher
• Carolina Bravo

• Social Worker in East Orange, NJ
• Providers in East Orange, NJ by specialty
• Social Worker in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.