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General NPI Number Information
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NPI Number | 1215338918
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Entity Type | Individual
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Provider Name | CARRIE LYN HANSON-BRADLEY LMFT
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Gender | Female
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Dates
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Enumeration Date | 09/12/2014
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Last Update Date | 10/29/2015
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Provider Practice Location Address
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Address Line | 4535 NORMAL BLVD SUITE 212
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City | LINCOLN
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State | NE
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Zip | 68506-5576
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Country | US
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Telephone | 402-413-9994
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Fax |
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Provider Business Mailing Address
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Address Line | 3070 STRATFORD AVE
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City | LINCOLN
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State | NE
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Zip | 68502-4246
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Country | US
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Telephone | 801-631-7866
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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 | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 1998
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License Number State | MN
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Taxonomy #2
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 1459
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License Number State | NE
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