Active NPI
William Raymond Bradley
- Mental Health Counselor
- Springfield, MA
National Provider Identifier
1962051219
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 6525
- Practice address
- 332 Birnie Ave
Springfield, MA 01107-1104 - Phone
- (413) 733-6624
- NPI assigned
- Sep 10, 2019
- 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 |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 6525 | CT | Primary |
Addresses
Primary practice location
332 Birnie Ave
Springfield, MA 01107-1104
Mailing address
72 Prospect St
Stafford Springs, CT 06076-1125
Phone (860) 458-8008
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 6525 | Other | CT | LPC LICENSURE |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1568073600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1698278400000",
"number": "1962051219",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "72 PROSPECT ST",
"city": "STAFFORD SPRINGS",
"state": "CT",
"postal_code": "060761125",
"telephone_number": "860-458-8008"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "332 BIRNIE AVE",
"city": "SPRINGFIELD",
"state": "MA",
"postal_code": "011071104",
"telephone_number": "413-733-6624"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRADLEY",
"first_name": "WILLIAM",
"middle_name": "RAYMOND",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2019-09-10",
"last_updated": "2023-10-26",
"certification_date": "2023-10-26",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Counselor, Mental Health",
"state": "CT",
"license": "6525",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LPC LICENSURE",
"identifier": "6525",
"state": "CT"
}
],
"endpoints": [],
"other_names": []
}Other providers in Springfield, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.