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General NPI Number Information
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NPI Number | 1457668543
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Entity Type | Organization
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Legal Business Name | BRADFORD ASSOCIATES
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Dates
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Enumeration Date | 09/10/2010
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Last Update Date | 09/10/2010
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Provider Practice Location Address
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Address Line | 103 BRADFORD COURT
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City | SOUTHERN PINES
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State | NC
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Zip | 28387
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Country | US
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Telephone | 910-692-2947
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Fax | 910-692-4147
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Provider Business Mailing Address
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Address Line | 103 BRADFORD COURT
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City | SOUTHERN PINES
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State | NC
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Zip | 28387
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Country | US
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Telephone | 910-692-2947
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Fax | 910-692-4147
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Authorized Official
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Title or Position | SOLE PROPRIETOR
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Name | MS. LORRAINNE ALICE BILODEAU
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Credential | LCAS, CCS
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Telephone | 910-692-2947
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 234
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | A7667
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License Number State | NC
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Taxonomy #3
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 5329
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License Number State | NC
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Taxonomy #4
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 8093
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License Number State | NC
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Taxonomy #5
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 8093
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License Number State | NC
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