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General NPI Number Information
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NPI Number | 1174937510
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Entity Type | Individual
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Provider Name | BRAD HAMBRIC MA, NCC, LPC-A
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Gender | Male
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Dates
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Enumeration Date | 06/13/2014
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Last Update Date | 06/13/2014
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Provider Practice Location Address
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Address Line | 1306 PADDOCK DR SUITE E-100
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City | RALEIGH
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State | NC
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Zip | 27609-4873
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Country | US
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Telephone | 919-599-8513
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Fax |
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Provider Business Mailing Address
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Address Line | 308 CALLANDALE LN
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City | DURHAM
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State | NC
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Zip | 27703-9803
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Country | US
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Telephone | 919-599-8513
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | A10844
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License Number State | NC
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