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General NPI Number Information
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NPI Number | 1972671261
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Entity Type | Individual
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Provider Name | STEPHEN JAMES BRADLEY LICSW, LMHC
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Gender | Male
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Dates
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Enumeration Date | 12/02/2006
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Last Update Date | 12/22/2016
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Provider Practice Location Address
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Address Line | 8 TRUMBULL RD SUITE 202
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City | NORTHAMPTON
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State | MA
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Zip | 01060-3079
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Country | US
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Telephone | 413-588-8423
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Fax | 888-981-8746
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Provider Business Mailing Address
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Address Line | PO BOX 914
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City | HAYDENVILLE
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State | MA
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Zip | 01039-0914
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Country | US
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Telephone | 413-522-0838
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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 | 4592
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License Number State | MA
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 117405
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License Number State | MA
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