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NPI Code Detail

MEDICARE: LEAH JO BRADFORD LCSW

MEDICARE: LEAH JO BRADFORD LCSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social Worker34008824AIN
2104100000XSocial Worker

General Provider Information

NPI Number : 1356797146
Entity Type Code : Individual
Provider Name (Legal Business Name) : LEAH JO BRADFORD LCSW
Provider Business Mailing Address
First Line : PO BOX 637764
Second Line :
City : CINCINNATI
State : OH
Zip : 45263-7764
Country : US
Telephone Number : 317-880-3939
Fax Number :
Provider Business Practice Location Address
First Line : 5610 CRAWFORDSVILLE RD STE 2201
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46224-3784
Country : US
Telephone Number : 317-244-2792
Fax Number : 317-243-2328
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/11/2016
Last Update Date : 09/11/2025

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Directions to “ LEAH JO BRADFORD LCSW” Practice Location

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