Provider Demographics
NPI:1285181859
Name:KERSCHENSTEINER, BRADLEY (MA)
Entity Type:Individual
Prefix:MR
First Name:BRADLEY
Middle Name:
Last Name:KERSCHENSTEINER
Suffix:
Gender:M
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:975 WEST 41ST STREET
Mailing Address - Street 2:SUITE 303
Mailing Address - City:MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33140
Mailing Address - Country:US
Mailing Address - Phone:786-201-4543
Mailing Address - Fax:
Practice Address - Street 1:975 W 41ST ST
Practice Address - Street 2:SUITE 303
Practice Address - City:MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33140-3329
Practice Address - Country:US
Practice Address - Phone:786-201-4543
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-01
Last Update Date:2016-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL2257106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist