Provider Demographics
NPI:1356726145
Name:SMEDLEY, BRAD RICHARD (LMFT)
Entity type:Individual
Prefix:MR
First Name:BRAD
Middle Name:RICHARD
Last Name:SMEDLEY
Suffix:
Gender:M
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3675 N SCOTCH PINE LN APT 3
Mailing Address - Street 2:
Mailing Address - City:COEUR D ALENE
Mailing Address - State:ID
Mailing Address - Zip Code:83815-1899
Mailing Address - Country:US
Mailing Address - Phone:509-989-4935
Mailing Address - Fax:
Practice Address - Street 1:5920 N GOVERNMENT WAY STE 4
Practice Address - Street 2:
Practice Address - City:DALTON GARDENS
Practice Address - State:ID
Practice Address - Zip Code:83815-9200
Practice Address - Country:US
Practice Address - Phone:509-989-4935
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-22
Last Update Date:2024-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALF60804635101YM0800X
IDLMFT-7872101YM0800X, 106H00000X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist