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NPI Code Detail

MEDICARE: DAKOTA SHAWN BRAGG

MEDICARE: DAKOTA SHAWN BRAGG
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
1101Y00000XCounselor
2101YA0400XAddiction (Substance Use Disorder) Counselor

General Provider Information

NPI Number : 1598532343
Entity Type Code : Individual
Provider Name (Legal Business Name) : DAKOTA SHAWN BRAGG
Provider Business Mailing Address
First Line : 115 CRESTVIEW TER APT 4
Second Line :
City : BRIDGEPORT
State : WV
Zip : 26330-1092
Country : US
Telephone Number : 304-651-7081
Fax Number :
Provider Business Practice Location Address
First Line : 106 TOLLEY DR
Second Line :
City : BRIDGEPORT
State : WV
Zip : 26330-1668
Country : US
Telephone Number : 865-378-6929
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/11/2023
Last Update Date : 04/06/2026

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Directions to “ DAKOTA SHAWN BRAGG ” Practice Location

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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.

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