Individual provider · Type 1 NPI
Jessica Bradley, LCMHCA
Professional Counselor · Lake Waccamaw, NC
NPI number
1518548577
Active
Practice location
104 East Old US Hwy 74/76
Lake Waccamaw, NC 28450
Mailing address
PO Box 127
Lake Waccamaw, NC 28450-0127
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Professional Counselor Primary | 101YP2500X | A16116 (NC) |
Professional Counselor: Definition to come...
About NPI 1518548577
Jessica Bradley, LCMHCA's National Provider Identifier is 1518548577, issued on Apr 20, 2021. The primary taxonomy on file is Professional Counselor (101YP2500X), and the practice location is in Lake Waccamaw, NC. The record was last updated on Apr 20, 2021.