MEDICARE: MR. BRAD NOWLIN LMFT

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	106H00000X	Marriage & Family Therapist	326	KS

General Provider Information

NPI Number	:	1609973288
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. BRAD NOWLIN LMFT

Provider Business Mailing Address
First Line	:	9101 W 128TH ST
Second Line	:
City	:	OVERLAND PARK
State	:	KS
Zip	:	66213-3018
Country	:	US
Telephone Number	:	913-579-8526
Fax Number	:	817-886-8489

Provider Business Practice Location Address
First Line	:	550 BAILEY AVE
Second Line	:	235
City	:	FORT WORTH
State	:	TX
Zip	:	76107-2155
Country	:	US
Telephone Number	:	913-579-8526
Fax Number	:	817-886-8489

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

Provider Enumeration Date	:	09/17/2006
Last Update Date	:	06/20/2016

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Directions to “ MR. BRAD NOWLIN LMFT” Practice Location

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