Provider Demographics
NPI:1578691937
Name:HUNT, BRADLEY C (LPC)
Entity Type:Individual
Prefix:MR
First Name:BRADLEY
Middle Name:C
Last Name:HUNT
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 1:1815 WYNWOOD DR
Mailing Address - Street 2:
Mailing Address - City:CARTHAGE
Mailing Address - State:MO
Mailing Address - Zip Code:64836-3327
Mailing Address - Country:US
Mailing Address - Phone:417-358-4265
Mailing Address - Fax:
Practice Address - Street 1:2000 GRAND AVE
Practice Address - Street 2:
Practice Address - City:CARTHAGE
Practice Address - State:MO
Practice Address - Zip Code:64836-3520
Practice Address - Country:US
Practice Address - Phone:417-358-4265
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-28
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2002027401101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional