MEDICARE: BRADLEY RECOVERY CENTER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	103TC0700X	Clinical Psychologist
2	1041C0700X	Clinical Social Worker
3	101Y00000X	Counselor
4	101YA0400X	Addiction (Substance Use Disorder) Counselor
5	101YM0800X	Mental Health Counselor
6	363LP0808X	Psychiatric/Mental Health Nurse Practitioner
7	364SA2100X	Acute Care Clinical Nurse Specialist
8	207R00000X	Internal Medicine Physician
9	2083A0300X	Addiction Medicine (Preventive Medicine) Physician
10	2084A0401X	Addiction Medicine (Psychiatry & Neurology) Physician
11	2084P0800X	Psychiatry Physician
12	363LA2200X	Adult Health Nurse Practitioner
13	363LF0000X	Family Nurse Practitioner

General Provider Information

NPI Number	:	1013736438
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BRADLEY RECOVERY CENTER

Provider Business Mailing Address
First Line	:	10400 DIXIE HWY STE 103
Second Line	:
City	:	LOUISVILLE
State	:	KY
Zip	:	40272-5913
Country	:	US
Telephone Number	:	502-409-4013
Fax Number	:

Provider Business Practice Location Address
First Line	:	10400 DIXIE HWY STE 103
Second Line	:
City	:	LOUISVILLE
State	:	KY
Zip	:	40272-5913
Country	:	US
Telephone Number	:	502-409-4013
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MR. MICHAEL PICKETT
Credential	:
Telephone Number	:	859-619-5659

Provider Enumeration Date	:	10/03/2024
Last Update Date	:	07/09/2025

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Directions to “BRADLEY RECOVERY CENTER ” Practice Location

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