Healthcare Provider Details

I. General information

NPI: 1609798438
Provider Name (Legal Business Name): DONNA MARIE BRADBURY LMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/25/2026
Last Update Date: 07/25/2026
Certification Date: 07/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6 AUTOMATION LN
ALBANY NY
12205-1668
US

IV. Provider business mailing address

10 HY DR
EAST SCHODACK NY
12063-1732
US

V. Phone/Fax

Practice location:
  • Phone: 518-892-8051
  • Fax:
Mailing address:
  • Phone: 518-892-8051
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number003534-01
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: