MEDICARE: KENDRA BRADFORD LPC-MHSP

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor	6769	TN

General Provider Information

NPI Number	:	1174405427
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KENDRA BRADFORD LPC-MHSP

Provider Business Mailing Address
First Line	:	124 SHIAWAY CT
Second Line	:
City	:	NASHVILLE
State	:	TN
Zip	:	37217-2528
Country	:	US
Telephone Number	:	615-870-7094
Fax Number	:

Provider Business Practice Location Address
First Line	:	6201 CORINTH RD
Second Line	:
City	:	MT JULIET
State	:	TN
Zip	:	37122-7603
Country	:	US
Telephone Number	:	615-973-5454
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/25/2025
Last Update Date	:	07/25/2025

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