Healthcare Provider Details

I. General information

NPI: 1609000173
Provider Name (Legal Business Name): BRADFORD HETZLER PRICE PH.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/12/2009
Last Update Date: 04/04/2026
Certification Date: 04/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

831 SOUTHWESTERN RUN STE 2
POLAND OH
44514-3694
US

IV. Provider business mailing address

4461 TIMBERDALE DR
STOW OH
44224-1831
US

V. Phone/Fax

Practice location:
  • Phone: 330-726-2965
  • Fax: 330-726-0449
Mailing address:
  • Phone: 330-671-9906
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP1600X
TaxonomyPastoral Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberC 0500197
License Number StateOH
# 3
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number862275
License Number StateOH
# 4
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberC 0500197
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: