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NPI Code Detail

MEDICARE: JESSICA BRADFIELD M.ED., LPC

MEDICARE: JESSICA BRADFIELD M.ED., 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
1101YP2500XProfessional Counselor

General Provider Information

NPI Number : 1730787011
Entity Type Code : Individual
Provider Name (Legal Business Name) : JESSICA BRADFIELD M.ED., LPC
Provider Business Mailing Address
First Line : 104 KENDALL CV
Second Line :
City : ELGIN
State : TX
Zip : 78621-5825
Country : US
Telephone Number : 760-628-8475
Fax Number :
Provider Business Practice Location Address
First Line : 601 FARLEY DR
Second Line :
City : AUSTIN
State : TX
Zip : 78753-3114
Country : US
Telephone Number : 512-504-7381
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/09/2020
Last Update Date : 10/09/2020

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