Provider Demographics
NPI:1619460672
Name:BRADT, CHRISTOPHER KENNETH (LPC, LMHC)
Entity Type:Individual
Prefix:MR
First Name:CHRISTOPHER
Middle Name:KENNETH
Last Name:BRADT
Suffix:
Gender:M
Credentials:LPC, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 GREENWICH ST STE 403
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10006-1895
Mailing Address - Country:US
Mailing Address - Phone:917-261-4414
Mailing Address - Fax:
Practice Address - Street 1:245 5TH AVE FL 3
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-8728
Practice Address - Country:US
Practice Address - Phone:917-261-4414
Practice Address - Fax:917-261-4420
Is Sole Proprietor?:No
Enumeration Date:2018-06-13
Last Update Date:2021-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC6854101Y00000X
NY010893101YP2500X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional