Jessica Lauren Bradway, LPC, ATR, LMT

Primary specialty

CounselorTaxonomy code 101Y00000X

License

6563-125 Issued in WI

Practice address

2230 S Kinnickinnic Ave
Milwaukee, WI 53207-1330

Phone

(414) 758-4643

NPI assigned

Jan 21, 2019

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

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

{
    "created_epoch": "1548028800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1548028800000",
    "number": "1922572262",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2249 S WOODWARD ST",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532071315",
            "telephone_number": "414-758-4643"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2230 S KINNICKINNIC AVE",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532071330",
            "telephone_number": "414-758-4643"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRADWAY",
        "first_name": "JESSICA",
        "middle_name": "LAUREN",
        "credential": "LPC, ATR, LMT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-01-21",
        "last_updated": "2019-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "WI",
            "license": "6563-125",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• William Hampton Bradley, M.D.
• Azore-Dee Bradshaw, M.D.
• Madeline Bradshaw, PT, DPT
• Tekeya A Bradshaw, LPC-IT
• Shirley Bradt, PT
• Brady East STD Clinic, Inc.
• Erica Brady
• Sara Brady, M.D.
• Shelley Lee Bragg
• Angela Braggs, LPC-IT

• Counselor in Milwaukee, WI
• Providers in Milwaukee, WI by specialty
• Counselor in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2019; 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.