Bradley Warren Holt, MSW, LMSW

Primary specialty

Social WorkerTaxonomy code 104100000X

License

LMSW-33841 Issued in ID

Practice address

323 12TH Ave Rd
Nampa, ID 83686-5014

Phone

(208) 463-0212

Fax

(208) 461-5452

NPI assigned

May 21, 2014

Last updated

May 21, 2014By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Montgomery Counseling Center

  • Mental Health Counselor
  • Nampa, ID
  • NPI 1255412714
  NPD (past)

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

{
    "created_epoch": "1400630400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1400630400000",
    "number": "1881006146",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1971 W MARTEN CREEK DR",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836464670",
            "telephone_number": "208-724-6460"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "323 12TH AVE RD",
            "city": "NAMPA",
            "state": "ID",
            "postal_code": "836865014",
            "telephone_number": "208-463-0212",
            "fax_number": "208-461-5452"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLT",
        "first_name": "BRADLEY",
        "middle_name": "WARREN",
        "name_prefix": "Mr.",
        "credential": "MSW, LMSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-05-21",
        "last_updated": "2014-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "ID",
            "license": "LMSW-33841",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE OF IDAHO, OFFICE OF OCCUPATIONAL LICENSES, STATE BOARD OF SOCIAL WORK",
            "identifier": "LMSW-33841",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Social Worker in Nampa, ID
• Providers in Nampa, ID by specialty
• Social Worker in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2014; 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.