MEDICARE: MR. JOHN FRANKLYN BRADSHAW M.S.,LMFT

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
1	106H00000X	Marriage & Family Therapist	1049	NC
2	106H00000X	Marriage & Family Therapist	F0070	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	13884	OTHER	NC	BLUE CROSS BLUE SHIELD

General Provider Information

NPI Number	:	1518021294
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. JOHN FRANKLYN BRADSHAW M.S.,LMFT

Provider Business Mailing Address
First Line	:	924 HORSETRAIL WAY
Second Line	:
City	:	WAKE FOREST
State	:	NC
Zip	:	27587-4605
Country	:	US
Telephone Number	:	919-497-5400
Fax Number	:	919-497-5407

Provider Business Practice Location Address
First Line	:	215 S BICKETT BLVD
Second Line	:
City	:	LOUISBURG
State	:	NC
Zip	:	27549-2607
Country	:	US
Telephone Number	:	919-497-4500
Fax Number	:	919-497-5407

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/20/2006
Last Update Date	:	01/11/2026

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