Healthcare Provider Details

I. General information

NPI: 1780594457
Provider Name (Legal Business Name): BRITTNEY BRADSHAW CSW, LSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/08/2026
Last Update Date: 09/08/2026
Certification Date: 09/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

435 BERGER RD
PADUCAH KY
42003-4501
US

IV. Provider business mailing address

2498 DEER RUN RD
METROPOLIS IL
62960-6031
US

V. Phone/Fax

Practice location:
  • Phone: 270-538-9831
  • Fax:
Mailing address:
  • Phone: 940-368-3672
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number150.119087
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberCSW00001417
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: