Provider Demographics
NPI:1326170812
Name:BRADLEY-BULL, STEVE MICHAEL (LPC)
Entity Type:Individual
Prefix:MR
First Name:STEVE
Middle Name:MICHAEL
Last Name:BRADLEY-BULL
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1305 MARYLAND AVE
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27705-3214
Mailing Address - Country:US
Mailing Address - Phone:919-286-5770
Mailing Address - Fax:
Practice Address - Street 1:1305 MARYLAND AVE
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27705-3214
Practice Address - Country:US
Practice Address - Phone:919-286-5770
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC6452101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health