Provider Demographics
NPI:1477324911
Name:BARBARA A BRADSHAW, LCPC, LLC
Entity Type:Organization
Organization Name:BARBARA A BRADSHAW, LCPC, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:BARBARA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:BRADSHAW
Authorized Official - Suffix:
Authorized Official - Credentials:LCPC
Authorized Official - Phone:443-860-1252
Mailing Address - Street 1:111 WARREN RD STE 10A
Mailing Address - Street 2:
Mailing Address - City:COCKEYSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21030-2452
Mailing Address - Country:US
Mailing Address - Phone:443-860-1252
Mailing Address - Fax:410-891-8277
Practice Address - Street 1:111 WARREN RD STE 10A
Practice Address - Street 2:
Practice Address - City:COCKEYSVILLE
Practice Address - State:MD
Practice Address - Zip Code:21030-2452
Practice Address - Country:US
Practice Address - Phone:443-860-1252
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-12
Last Update Date:2024-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health