Provider Demographics
NPI:1437898087
Name:BRADSHAW, CHRISTOPHER DEAN (LPC)
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:DEAN
Last Name:BRADSHAW
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 1:19157 SHADOW SPRINGS CT
Mailing Address - Street 2:
Mailing Address - City:JEFFERSONTON
Mailing Address - State:VA
Mailing Address - Zip Code:22724-2249
Mailing Address - Country:US
Mailing Address - Phone:540-905-1484
Mailing Address - Fax:
Practice Address - Street 1:170 W SHIRLEY AVE
Practice Address - Street 2:
Practice Address - City:WARRENTON
Practice Address - State:VA
Practice Address - Zip Code:20186-2877
Practice Address - Country:US
Practice Address - Phone:540-905-1484
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-01
Last Update Date:2022-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701011455101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional