Active NPI
Bradley Thomas Conley, MA LADC
- Addiction (Substance Use Disorder) Counselor
- Roseville, MN
National Provider Identifier
1962987560
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- 304255
- Practice address
- 2233 Hamline Ave N Ste 110
Roseville, MN 55113-5002 - Phone
- (651) 447-3755
- NPI assigned
- Sep 28, 2018
- Last updated
- Sep 28, 2018
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 304255 | MN | Primary |
Addresses
Primary practice location
2233 Hamline Ave N Ste 110
Roseville, MN 55113-5002
Mailing address
2233 Hamline Ave N Ste 110
Roseville, MN 55113-5002
Phone (651) 447-3755
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
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 304255 | MN | MD | Addiction (Substance Use Disorder) Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1538092800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1538092800000",
"number": "1962987560",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2233 HAMLINE AVE N STE 110",
"city": "ROSEVILLE",
"state": "MN",
"postal_code": "551135002",
"telephone_number": "651-447-3755"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2233 HAMLINE AVE N STE 110",
"city": "ROSEVILLE",
"state": "MN",
"postal_code": "551135002",
"telephone_number": "651-447-3755"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CONLEY",
"first_name": "BRADLEY",
"middle_name": "THOMAS",
"credential": "MA LADC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-09-28",
"last_updated": "2018-09-28",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "MN",
"license": "304255",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Roseville, MN
- Community Drug & Alcohol Services Inc (Options Family & Behavior Services)
- Community Drug& Alcohol Services Inc (OPTIONS Family & Behavior Services)
- Community Medical Services Montana-Private, LLC (Community Medical Services)
- Community Medical Services Montana-Private, LLC (CMS Roseville)
- Comprehensive Health & Wellness
- Brian Conley, MD
- Crystal Connolly, CRNA
- Ann Marie Connor, M.D.
- Sarah M Conway, LICSW
- Copeland's Sleep Solutions
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.