CRYSTAL D BRADSHAW (NPI# 1699908434) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1699908434 |
| Entity Type | Individual |
| Full Name | CRYSTAL D BRADSHAW |
| Credential | LPC |
| Practice Address |
3225 Shallowford Rd Suite 710 Marietta GA 30062-1266 |
| Practice Telephone | 7703649005 |
| Mailing Telephone | 7703649005 |
| Enumeration Date | 2009-08-27 |
| Last Update Date | 2014-03-16 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YP2500X |
Counselor Specialization: Professional |
LPC006953 | GA | Behavioral Health & Social Service Providers |
| Street Address |
3225 SHALLOWFORD RD SUITE 710 |
| City | MARIETTA |
| State | GA |
| Zip Code | 30062-1266 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225012156 | Suzanne M Clous | Podiatrist | 3225 Shallowford Rd, Suite 200, Marietta, GA 30062-1266 | 2005-12-05 |
| 1891323093 | Sara Moore | Psychiatry & Neurology | 3225 Shallowford Rd, Marietta, GA 30062-1266 | 2020-04-01 |
| 1831594373 | Jean Elizabeth Blond | Speech-Language Pathologist | 3225 Shallowford Rd, Bldg 1100, Ste 1120, Marietta, GA 30062-1266 | 2014-10-27 |
| 1568863215 | Kathryne Brooke Drucker | Nurse Practitioner | 3225 Shallowford Rd, Marietta, GA 30062-1266 | 2014-09-12 |
| 1396144317 | Begin Within Therapy | Counselor | 3225 Shallowford Rd, Suite 710, Marietta, GA 30062-1266 | 2014-08-14 |
| 1356754485 | Jaime Emry | Speech-Language Pathologist | 3225 Shallowford Rd, Bldg 1100, Ste 1120, Marietta, GA 30062-1266 | 2014-06-05 |
| 1366880577 | Kathryn Jones | Speech-Language Pathologist | 3225 Shallowford Rd, Bldg 1100, Ste 1120, Marietta, GA 30062-1266 | 2013-06-10 |
| 1609214170 | Berner Family Chiropractic LLC | Chiropractor | 3225 Shallowford Rd, Ste 700, Marietta, GA 30062-1266 | 2013-06-06 |
| 1619230620 | Imagine Counseling Services, LLC | Counselor | 3225 Shallowford Rd, Ste 710, Marietta, GA 30062-1266 | 2012-06-25 |
| 1841554888 | Kathy Haines | Counselor | 3225 Shallowford Rd, Suite 710, Marietta, GA 30062-1266 | 2012-06-25 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619578051 | Pamela D Kretzmer | Social Worker | 3855 Shallowford Road, Suite 420, Marietta, GA 30062 | 2020-11-03 |
| 1932714680 | Michelle Chambless | Physical Therapist | Team Rehabilitation Ga01, LLC, 1401 Johnson Ferry Road, Suite 340, Marietta, GA 30062 | 2020-09-10 |
| 1700408887 | Life University | Chiropractor | 1323 Roswell Road, Marietta, GA 30062 | 2020-05-12 |
| 1104451160 | Sno Healthcare Group | Clinic/Center | 2424 Roswell Rd Ste 120, Marietta, GA 30062 | 2020-03-10 |
| 1811536212 | Sandy Plains Dental Group, PC | Dentist | 3460 Sandy Plains Rd, Suite 240, Marietta, GA 30062 | 2020-01-02 |
| 1073159034 | Magdala Tulcie Jodesty-jackson | Social Worker | 4343 Shalloword Road, Building H, Suite 4 Lower Level, Marietta, GA 30062 | 2019-11-25 |
| 1598235178 | Matthew Driggers | Counselor | 4343 Shallowford Rd C2, Marietta, GA 30062 | 2018-11-27 |
| 1750895785 | Emily Grace Minday | Counselor | 4343 Shallowford Road Building C, Suite 1 Lower Level, Marietta, GA 30062 | 2017-11-29 |
| 1477072122 | Jason Lee Amos | Speech-Language Pathologist | 3660 Chestnut Ridge Court, Marietta, GA 30062 | 2017-09-13 |
| 1346761376 | Marian Pomaah Opoku-agyeman | Nurse Practitioner | 4661 Andrea Pointe, Marietta, GA 30062 | 2017-06-29 |
| Find all providers in zip 30062 | ||||
| Taxonomy Code | 101YP2500X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Professional |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659987238 | Kimberly Wallace Lpc LLC | Counselor | 2852 Johnson Ferry Rd Ste 100, Marietta, GA 30062-5686 | 2020-09-19 |
| 1073128609 | Alyssa May Rodriguez | Counselor | 2064 S Cove Trl, Marietta, GA 30066-1922 | 2020-09-10 |
| 1225642374 | April G Lewis | Counselor | 1640 Powers Ferry Rd Se Bldg 20, Marietta, GA 30067-5491 | 2020-09-06 |
| 1336751890 | Brandi Lynne Neogra | Counselor | 207 Colegate Dr Ste D, Marietta, OH 45750-2363 | 2020-08-17 |
| 1427672575 | Monique T Jones | Counselor | 2480 Windy Hill Rd Se Ste 105, Marietta, GA 30067-8608 | 2020-06-04 |
| 1588288864 | Patrick Wilson | Counselor | 1744 Roswell Rd Ste 102, Marietta, GA 30062-3979 | 2020-06-03 |
| 1407477193 | Michael Cynil Daniel | Counselor | 698 N Marietta, Pkwy, Marietta, GA 30060 | 2020-05-04 |
| 1851928857 | Patricia Li Zerman | Counselor | 1373 Old Virginia Ct Se, Marietta, GA 30067-8461 | 2020-03-27 |
| 1467089227 | Catherine Ibarra | Counselor | 1640 Powers Ferry Rd Se # 300, Marietta, GA 30067-5491 | 2020-03-23 |
| 1306487970 | Brooke Lopes | Counselor | 2655 Dallas Hwy Sw Ste 230, Marietta, GA 30064-2597 | 2019-10-03 |
| Find all providers in MARIETTA | ||||
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| 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.