Active NPI
Kailey Bradley
- Mental Illness Community Based Residential Treatment Facility
- Ashland, OH
National Provider Identifier
1962864348
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Illness Community Based Residential Treatment Facility
- License
- C1400418
- Practice address
- 80 Samaritan Ave Apt 1
Ashland, OH 44805-3924 - Phone
- (419) 589-5511
- NPI assigned
- Mar 24, 2016
- Last updated
- Mar 24, 2016
- Sex
- Female
- 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 Illness Community Based Residential Treatment Facility | 320800000X | C1400418 | OH | Primary |
Addresses
Primary practice location
80 Samaritan Ave Apt 1
Ashland, OH 44805-3924
Mailing address
80 Samaritan Ave Apt 1
Ashland, OH 44805-3924
Phone (419) 589-5511
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OH
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Mental Health Counselor
- Education
- Other, 2015
- Medicare assignment
- May accept Medicare assignment
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
Ashland, OH 44805
Phone (419) 922-9696
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| C1400418 | OH | MD | Mental Illness Community Based Residential Treatment Facility |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Refuge Counseling, LLC | Current | Accepting new patients |
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.
-
- Mental Health Counselor
- Ashland, OH
- NPI 1508463597
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1458777600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1458777600000",
"number": "1962864348",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "80 SAMARITAN AVE APT 1",
"city": "ASHLAND",
"state": "OH",
"postal_code": "448053924",
"telephone_number": "419-589-5511"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "80 SAMARITAN AVE APT 1",
"city": "ASHLAND",
"state": "OH",
"postal_code": "448053924",
"telephone_number": "419-589-5511"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRADLEY",
"first_name": "KAILEY",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-03-24",
"last_updated": "2016-03-24",
"status": "A"
},
"taxonomies": [
{
"code": "320800000X",
"taxonomy_group": "",
"desc": "Community Based Residential Treatment Facility, Mental Illness",
"state": "OH",
"license": "C1400418",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ashland, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.