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General NPI Number Information
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NPI Number | 1629568027
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Entity Type | Organization
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Legal Business Name | BRADSHAW COUNSELING AND CONSULTATION SERVICES LLC
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Dates
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Enumeration Date | 05/11/2018
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Last Update Date | 01/30/2025
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Provider Practice Location Address
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Address Line | 1141 E MAIN ST STE 200
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City | BATESVILLE
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State | AR
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Zip | 72501-3014
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Country | US
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Telephone | 870-376-2838
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Fax | 501-305-0189
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Provider Business Mailing Address
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Address Line | 405 W ARCH AVE
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City | SEARCY
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State | AR
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Zip | 72143-5202
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Country | US
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Telephone | 870-376-2838
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Fax | 510-305-0189
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Authorized Official
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Title or Position | PRACTICE ADMINISTRATOR/CO-FOUNDER
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Name | MR. JAMIE J BRADSHAW
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Credential |
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Telephone | 870-376-2838
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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 |
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License Number State |
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