Rebecca R Bradley, LCPC, LMFT,LMHC, NCC

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

Practice address

1250 W Ironwood Dr Ste 330
Coeur D Alene, ID 83814-2682

Phone

(208) 274-3020

Fax

(208) 561-7081

NPI assigned

May 8, 2019

Last updated

Oct 2, 2024By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Beachside Counseling LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Coeur d'Alene, ID
  • NPI 1104599331
  NPD Authorized official
• Children's Home Society of Washington

  dba Akin

  • Community/Behavioral Health Agency
  • Spokane Valley, WA
  • NPI 1013061811
  NPD (past)

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

{
    "created_epoch": "1557273600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727827200000",
    "number": "1962067652",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1250 W IRONWOOD DR STE 330",
            "city": "COEUR D ALENE",
            "state": "ID",
            "postal_code": "838142682",
            "telephone_number": "208-274-3020",
            "fax_number": "208-561-7081"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1250 W IRONWOOD DR STE 330",
            "city": "COEUR D ALENE",
            "state": "ID",
            "postal_code": "838142682",
            "telephone_number": "208-274-3020",
            "fax_number": "208-561-7081"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRADLEY",
        "first_name": "REBECCA",
        "middle_name": "R",
        "credential": "LCPC, LMFT,LMHC, NCC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-05-08",
        "last_updated": "2024-10-02",
        "certification_date": "2024-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "ID",
            "license": "LCPC-9186",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Daniel Boylan
• Catherine A Boysen, DIETICIAN
• Chandler Bozarth, DDS
• Nina Sienna Bozinov, M.D.
• Heidi Rose Brackebusch, RDN
• Brittney C Brady, PA-C
• Rena L Bradymire, LPC
• Michael L Brandt, PHARMD
• Michah Brasseur, M.D.
• Jillienne Braucher Sells, DPT

• Marriage & Family Therapist in Coeur d'Alene, ID
• Providers in Coeur d'Alene, ID by specialty
• Marriage & Family Therapist in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2024; 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.