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General NPI Number Information
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NPI Number | 1083113724
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Entity Type | Organization
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Legal Business Name | BRAD EPPLEY M.A., LMHC
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Dates
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Enumeration Date | 02/08/2018
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Last Update Date | 02/08/2018
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Provider Practice Location Address
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Address Line | 5987 SNOWY EGRET DR
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City | SARASOTA
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State | FL
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Zip | 34238-3760
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Country | US
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Telephone | 941-224-3464
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Fax |
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Provider Business Mailing Address
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Address Line | 5987 SNOWY EGRET DR
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City | SARASOTA
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State | FL
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Zip | 34238-3760
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Country | US
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Telephone | 941-224-3464
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Fax |
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Authorized Official
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Title or Position | LMHC
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Name | PAIGE BRADLEY (BRAD) EPPLEY
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Credential | M.A.
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Telephone | 941-224-3464
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | MH5614
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License Number State | FL
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