Active NPI
Terry Steven Bradford, PHD
- Clinical Psychologist
- Livonia, MI
National Provider Identifier
1952503096
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 6301 000005212
- Practice address
- 17290 Farmington Rd
Livonia, MI 48152-3151 - Phone
- (734) 523-8482
- Fax
- (734) 523-8489
- NPI assigned
- Jun 1, 2007
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 6301 000005212 | MI | Primary |
Addresses
Primary practice location
17290 Farmington Rd
Livonia, MI 48152-3151
Mailing address
17290 Farmington Rd
Livonia, MI 48152-3151
Phone (734) 523-8482
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
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6301 000005212 | MI | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1180656000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1952503096",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "17290 FARMINGTON RD",
"city": "LIVONIA",
"state": "MI",
"postal_code": "481523151",
"telephone_number": "734-523-8482",
"fax_number": "734-523-8489"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "17290 FARMINGTON RD",
"city": "LIVONIA",
"state": "MI",
"postal_code": "481523151",
"telephone_number": "734-523-8482",
"fax_number": "734-523-8489"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRADFORD",
"first_name": "TERRY",
"middle_name": "STEVEN",
"name_prefix": "Dr.",
"credential": "PHD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-06-01",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "MI",
"license": "6301 000005212",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Livonia, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.