MEDICARE: EMILY BRADSHAW LPC

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	101YM0800X	Mental Health Counselor	89057	TX

General Provider Information

NPI Number	:	1609504778
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EMILY BRADSHAW LPC

Provider Business Mailing Address
First Line	:	21212 NORTHWEST FWY STE 455
Second Line	:
City	:	CYPRESS
State	:	TX
Zip	:	77429-6070
Country	:	US
Telephone Number	:	832-237-2673
Fax Number	:

Provider Business Practice Location Address
First Line	:	21212 NORTHWEST FWY STE 455
Second Line	:
City	:	CYPRESS
State	:	TX
Zip	:	77429-6070
Country	:	US
Telephone Number	:	832-237-2673
Fax Number	:

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

Provider Enumeration Date	:	08/08/2022
Last Update Date	:	03/30/2026

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