Healthcare Provider Details

I. General information

NPI: 1134839723
Provider Name (Legal Business Name): BRADLEY JAMES SCHOPF LPCC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/05/2022
Last Update Date: 12/05/2022
Certification Date: 12/05/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3231 1ST AVE S
MINNEAPOLIS MN
55408-4407
US

IV. Provider business mailing address

3601 2ND AVE S
MINNEAPOLIS MN
55409-1319
US

V. Phone/Fax

Practice location:
  • Phone: 612-238-6215
  • Fax:
Mailing address:
  • Phone: 612-296-7776
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number3625
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: