Joshua Allen Bradshaw
Individual provider Active NPI Mental Health Counselor · Bridgeview, IL
NPI 1972120087 · NPPES record last updated Aug 17, 2026
Key facts
- NPI
- 1972120087
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Mental Health Counselor 101YM0800X
- Practice address
- 8104 Odell Ave
Bridgeview, IL 60455-1622 - Phone
- (951) 415-2895
- NPI assigned
- Jul 6, 2020
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Oct 28, 2025 through Oct 28, 2027
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | Yes |
Addresses
Primary practice location
8104 Odell Ave
Bridgeview, IL 60455-1622
Mailing address
8104 Odell Ave
Bridgeview, IL 60455-1622
Phone (951) 415-2895
Other practice location 1
2923 NE Broadway St
Portland, OR 97232-1760
Phone (503) 941-0856
Other providers in Bridgeview, IL
- Valerie Lynn Bennecke
- Angela Bertucci
- Katherine Leigh Bertucci
- James Boblak
- Kathleen Bordelon
- Bridgeview Dental Management
- Bridgeview Foot and Ankle, P.C.
- Bridgeview Health Care Center, LTD.
- Bridgeview Medical Center LTD
- Bridgeview Pediatrics, P.C.
All providers in Bridgeview, IL · Mental Health Counselor in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 17, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Opt Out Affidavits (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.