Active NPI
Ian William Bradshaw, LPC
- Professional Counselor
- Batesville, AR
National Provider Identifier
1881848265
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- P1411090
- Practice address
- 1141 E Main St Ste 200
Batesville, AR 72501-3014 - Phone
- (877) 994-5569
- NPI assigned
- Nov 11, 2008
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | P1411090 | AR | |
| Professional Counselor | 101YP2500X | P1411090 | AR | Primary |
Addresses
Primary practice location
1141 E Main St Ste 200
Batesville, AR 72501-3014
Mailing address
3 River Oaks Blvd
Searcy, AR 72143-4503
Phone (501) 322-9541
Other practice location 1
120 Meghan Ln
Judsonia, AR 72081-9302
Phone (866) 729-4479
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 |
|---|---|---|---|
| P1411090 | AR | MD | Mental Health Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Bradshaw Counseling and Consultation Services LLC | Mental Health | Current | Accepting new patients |
Locations
1141 E Main St
Ste 200
Batesville, AR 72501
Phone (870) 793-3199
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Willow Tree Counseling and Consultation Services LLC
- Mental Health Counselor
- Batesville, AR
- NPI 1629568027
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1226361600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1525996800000",
"number": "1881848265",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3 RIVER OAKS BLVD",
"city": "SEARCY",
"state": "AR",
"postal_code": "721434503",
"telephone_number": "501-322-9541"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1141 E MAIN ST STE 200",
"city": "BATESVILLE",
"state": "AR",
"postal_code": "725013014",
"telephone_number": "877-994-5569"
}
],
"practiceLocations": [
{
"address_1": "120 Meghan Ln",
"address_purpose": "LOCATION",
"city": "Judsonia",
"state": "AR",
"postal_code": "720819302",
"country_code": "US",
"telephone_number": "866-729-4479",
"fax_number": "501-729-3537",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "BRADSHAW",
"first_name": "IAN",
"middle_name": "WILLIAM",
"name_prefix": "Mr.",
"credential": "LPC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2008-11-11",
"last_updated": "2018-05-11",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "AR",
"license": "P1411090",
"primary": false
},
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "AR",
"license": "P1411090",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Batesville, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.