Provider Demographics
NPI:1558678870
Name:DOBSON, BRADLEY M (LMHC, LCAC, CADACII)
Entity Type:Individual
Prefix:
First Name:BRADLEY
Middle Name:M
Last Name:DOBSON
Suffix:
Gender:M
Credentials:LMHC, LCAC, CADACII
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5150 E STOP 11 RD
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46237-8628
Mailing Address - Country:US
Mailing Address - Phone:317-759-1203
Mailing Address - Fax:
Practice Address - Street 1:5150 E STOP 11 RD
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46237-8628
Practice Address - Country:US
Practice Address - Phone:317-759-1203
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-08
Last Update Date:2015-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health