MEDICARE: SHARI LYNN BRADSTREAM CCDC III

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	101YA0400X	Addiction (Substance Use Disorder) Counselor	07121348	SD

General Provider Information

NPI Number	:	1184916884
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHARI LYNN BRADSTREAM CCDC III

Provider Business Mailing Address
First Line	:	1101 E PHILADELPHIA ST
Second Line	:
City	:	RAPID CITY
State	:	SD
Zip	:	57701-1731
Country	:	US
Telephone Number	:	605-343-1620
Fax Number	:	605-343-1629

Provider Business Practice Location Address
First Line	:	1101 E PHILADELPHIA ST
Second Line	:
City	:	RAPID CITY
State	:	SD
Zip	:	57701-1731
Country	:	US
Telephone Number	:	605-343-1620
Fax Number	:	605-343-1629

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

Provider Enumeration Date	:	05/12/2011
Last Update Date	:	05/12/2011

Similar Medicare Providers

1518815158 — KRISTIN MARIE ZAORSKI
Practice Location Address:

312 BOULEVARD AVE
DICKSON CITY, PA
18519-1731

Practice Phone: 570-343-2383
Practice Fax: 570-230-0013

1336592328 — ZEBIDA T LISSO APRN
Practice Location Address:

1731 N 90TH ST
KANSAS CITY, KS
66112-1515

Practice Phone: 913-732-5903
Practice Fax:

1841290764 — SELECT SPECIALTY HOSPITAL - KANSAS CITY INC
Practice Location Address:

1731 NORTH 90TH STREET
KANSAS CITY, KS
66112-1689

Practice Phone: 913-732-5900
Practice Fax: 913-541-5830

1134224140 — GERALD WAYNE JOINES II DC
Practice Location Address:

1731 W EVERLY BROS BLVD
CENTRAL CITY, KY
42330

Practice Phone: 270-754-1335
Practice Fax: 270-757-9478

1154492023 — ACTS V HEALTH CARE SERVICES LLC
Practice Location Address:

4119 STILLWATER DR
MISSOURI CITY, TX
77459-1731

Practice Phone: 713-774-8950
Practice Fax: 713-774-8955

1033242045 — DR. NAEL DAGSTANI NMD
Practice Location Address:

1731 MESQUITE AVE STE 4
LAKE HAVASU CITY, AZ
86403-5653

Practice Phone: 480-861-3916
Practice Fax:

Directions to “ SHARI LYNN BRADSTREAM CCDC III” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.