Healthcare Provider Details

I. General information

NPI: 1992253348
Provider Name (Legal Business Name): BRAD CARMICHAEL MS.ED, LPC, NCC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/14/2016
Last Update Date: 09/04/2026
Certification Date: 09/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

492 E 13TH AVE STE 217
EUGENE OR
97401-4250
US

IV. Provider business mailing address

492 E 13TH AVE STE 217
EUGENE OR
97401-4250
US

V. Phone/Fax

Practice location:
  • Phone: 757-793-8325
  • Fax: 888-597-6612
Mailing address:
  • Phone: 757-793-8325
  • Fax: 888-597-6612

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberC8124
License Number StateOR
# 2
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberPC009176
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: