Provider Demographics
NPI:1033807243
Name:BRAD STEPP, PSYD LLC
Entity Type:Organization
Organization Name:BRAD STEPP, PSYD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PSYCHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:GARY
Authorized Official - Middle Name:BRADLEY
Authorized Official - Last Name:STEPP
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:812-329-5277
Mailing Address - Street 1:3100 E JOHN HINKLE PL STE 104
Mailing Address - Street 2:
Mailing Address - City:BLOOMINGTON
Mailing Address - State:IN
Mailing Address - Zip Code:47408-2611
Mailing Address - Country:US
Mailing Address - Phone:812-329-5277
Mailing Address - Fax:
Practice Address - Street 1:3100 E JOHN HINKLE PL STE 104
Practice Address - Street 2:
Practice Address - City:BLOOMINGTON
Practice Address - State:IN
Practice Address - Zip Code:47408-2611
Practice Address - Country:US
Practice Address - Phone:812-329-5277
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-26
Last Update Date:2023-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty