Provider Demographics
NPI:1184020992
Name:BRADLEY-BEELER, KATHRYN
Entity Type:Individual
Prefix:MRS
First Name:KATHRYN
Middle Name:
Last Name:BRADLEY-BEELER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1110 CHIRICAHUA LOOP
Mailing Address - Street 2:APT A
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80915-3287
Mailing Address - Country:US
Mailing Address - Phone:804-980-6226
Mailing Address - Fax:
Practice Address - Street 1:17 FARRAGUT AVE
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80909-5625
Practice Address - Country:US
Practice Address - Phone:719-327-2042
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-11-06
Last Update Date:2014-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health