Provider Demographics
NPI:1477169548
Name:SHEARER, BRADLEY (LCPC)
Entity Type:Individual
Prefix:MR
First Name:BRADLEY
Middle Name:
Last Name:SHEARER
Suffix:
Gender:M
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6087 FLAGSTONE CT
Mailing Address - Street 2:
Mailing Address - City:FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:21701-5847
Mailing Address - Country:US
Mailing Address - Phone:410-440-4855
Mailing Address - Fax:
Practice Address - Street 1:6087 FLAGSTONE CT
Practice Address - Street 2:
Practice Address - City:FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:21701-5847
Practice Address - Country:US
Practice Address - Phone:410-440-4855
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-23
Last Update Date:2020-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLC10736101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health