BRADLEY DEAN GAULT (NPI# 1316396062) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1316396062 |
Entity Type | Individual |
Full Name | BRADLEY DEAN GAULT |
Credential | MA |
Practice Address |
98 Liberty Ln Mineral Wells WV 26150-1605 |
Practice Telephone | 3044822959 |
Mailing Telephone | 3044822959 |
Enumeration Date | 2016-06-03 |
Last Update Date | 2016-06-03 |
Gender Code | M |
Is Sole Proprietor | Y |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 103TC2200X |
Psychologist Specialization: Clinical Child & Adolescent |
859 | WV | Behavioral Health & Social Service Providers |
Street Address |
98 LIBERTY LN |
City | MINERAL WELLS |
State | WV |
Zip Code | 26150-1605 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1275192601 | First Settlement Physical Therapy | Clinic/Center | 1405 Elizabeth Pike, 103, Mineral Wells, WV 26150 | 2019-06-10 |
1063753077 | Toby D. Daggett | Occupational Therapist | 435 Society Hill Rd, Mineral Wells, WV 26150 | 2013-03-15 |
1255347571 | Mountain River Physical Therapy LLC | Clinic/Center | 63 Hospitality Lane, Suite 1, Mineral Wells, WV 26150 | 2006-07-31 |
1003884842 | Karen Lee Fahey | Nurse Practitioner | 272 Frontage Road, Mineral Wells, WV 26150 | 2006-03-09 |
1942411053 | Jeffrey Ray Haffner | Pharmacist | 1506 Elizabeth Pike, Mineral Wells, WV 26150 | 2007-05-24 |
1427268184 | John Irvin Mourat | Pharmacist | 1506 Elizabeth Pike, Mineral Wells, WV 26150 | 2007-05-23 |
1902959356 | Amy Carter | Physical Therapy Assistant | 63 Hospitality Lane, Suite 1, Mineral Wells, WV 26150 | 2007-01-19 |
1912050386 | Melody Vaught | Physical Therapy Assistant | 63 Hospitality Lane, Suite 1, Mineral Wells, WV 26150 | 2007-01-19 |
1841617644 | Mid-ohio Valley Chiropractic and Wellness | Clinic/Center | 7930 Pike St., Mineral Wells, WV 26150-0040 | 2014-03-19 |
1134590532 | Finbar G Powderly | Clinic/Center | 1578 Elizabeth Pike, Mineral Wells, WV 26150-0489 | 2015-10-12 |
Find all providers in zip 26150 |
Taxonomy Code | 103TC2200X |
Grouping | Behavioral Health & Social Service Providers |
Classification | Psychologist |
Specialization | Clinical Child & Adolescent |
Definition to come... |
Notes: [1/1/2007: title modified] |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1548482896 | Christina M. Arco, Phd Pllc | Psychologist | 1013 B Oakhurst Drive, Charleston, WV 25314 | 2007-05-03 |
1619041738 | Elizabeth A Jennings | Psychologist | 1705 Jefferson St, Bluefield, WV 24701-4013 | 2006-11-20 |
1548362247 | Holly A Cloonan | Psychologist | 3200 Maccorkle Ave Se Fl 5, Charleston, WV 25304-1227 | 2006-09-02 |
1073563185 | Christina M Arco | Psychologist | 1013b Oakhurst Dr, Charleston, WV 25314-2049 | 2006-05-11 |
1487904918 | Jocelyn Joy Brown | Psychologist | 800 Pennsylvania Ave, Charleston, WV 25302-3351 | 2012-09-12 |
1124275300 | Youth Health Service, Inc. | Psychologist | 971 Harrison Avenue, Elkins, WV 26241 | 2008-08-19 |
1164559860 | Tammy Morgan Hamner | Psychologist | 917 W Main St, Harron Square, Suite 203, Bridgeport, WV 26330-1650 | 2007-02-28 |
City | MINERAL WELLS |
Zip Code | 26150 |
Please comment or provide details below to improve the information on BRADLEY DEAN GAULT.
Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.