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General NPI Number Information
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NPI Number | 1558215251
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Entity Type | Individual
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Provider Name | BRADLEY GINN LPCC
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Gender | Male
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Dates
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Enumeration Date | 02/21/2026
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Last Update Date | 02/21/2026
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Provider Practice Location Address
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Address Line | 527 STATE ST
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City | BOWLING GREEN
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State | KY
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Zip | 42101-1242
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Country | US
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Telephone | 270-904-4005
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Fax |
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Provider Business Mailing Address
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Address Line | 3259 SPRING HOLLOW AVE APT D
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City | BOWLING GREEN
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State | KY
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Zip | 42104-4870
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Country | US
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Telephone | 502-663-1911
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 296086
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License Number State | KY
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