DR. LONNIE BRADFORD (NPI# 1891020467) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1891020467 |
| Entity Type | Individual |
| Full Name | DR. LONNIE BRADFORD |
| Credential | PSY.D |
| Practice Address |
3812 8th St N Ste 200 Saint Cloud MN 56303-1421 |
| Practice Telephone | 5136120876 |
| Mailing Telephone | 5136120876 |
| Enumeration Date | 2009-10-15 |
| Last Update Date | 2019-11-22 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103G00000X | Clinical Neuropsychologist | 6007 | MN | Behavioral Health & Social Service Providers |
| N | 103TC0700X |
Psychologist Specialization: Clinical |
1673 | AL | Behavioral Health & Social Service Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 6900 Georgia Ave Nw, Washington, DC 203070003 | 2027820065 |
| Street Address |
3812 8TH ST N STE 200 |
| City | SAINT CLOUD |
| State | MN |
| Zip Code | 56303-1421 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962469171 | Jeffrey Kearney | Clinical Neuropsychologist | 3812 8th St N Ste 200, Saint Cloud, MN 56303-1421 | 2006-05-01 |
| 1043860109 | St. Cloud Neurobehavioral Associates, Pa | Psychologist | 3812 8th St N Ste 200, Saint Cloud, MN 56303-1421 | 2019-09-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841800463 | Daniel P Lahr | Radiologic Technologist | St Cloud Va Health Care System, 4801 Veterans Drive, St Cloud, MN 56303 | 2020-08-07 |
| 1730798398 | County of Stearns | Case Management | 705 Courthouse Square, St Cloud, MN 56303 | 2020-07-29 |
| 1669007126 | Aflah Transportation LLC | Non-emergency Medical Transport (VAN) | 3316 3rd Street North, Suite 129, Saint Cloud, MN 56303 | 2020-03-05 |
| 1609420942 | Stephanie Lynne Metzger | Nurse Practitioner | Centracare Clinic Riverc Ampus/nephrology, 1200 Sixth Ave North, St. Cloud, MN 56303 | 2019-07-25 |
| 1306406947 | Willow Tree Acupuncture LLC | Acupuncturist | 203 Cooper Ave N Suite 160, St. Cloud, MN 56303 | 2019-06-17 |
| 1821553520 | Alan Melvin Hoeper | Nurse Anesthetist, Certified Registered | Centracare Clinic Anesthesiology, 3701 12th St N, Suite 202, St. Cloud, MN 56303 | 2019-02-06 |
| 1437644465 | Brianna Larissa Justin | Speech-Language Pathologist | St. Cloud Hospital, 1406 6th Avenue N, St. Cloud, MN 56303 | 2018-06-22 |
| 1780186486 | Simplicity Health Pa | Family Medicine | 1511 Northway Dr Ste 103, Saint Cloud, MN 56303 | 2018-03-08 |
| 1639682925 | Dereje Beyene | Respiratory Therapist, Certified | 1406 15th Street North, Saint Cloud, MN 56303 | 2017-11-09 |
| 1740792761 | Lisa Ann Horner | Nurse Practitioner | 1555 Northway Drive #110, Centracare Complex Care Clinic, St Cloud, MN 56303 | 2017-10-31 |
| Find all providers in zip 56303 | ||||
| Taxonomy Code | 103G00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Clinical Neuropsychologist |
| An individual with a doctorate degree, licensure in clinical psychology and specialized training or board certification in neuropsychology who practices or adheres to the principles of neuropsychology; a specialty within the field of psychology focusing primarily on neurobehavioral functioning. |
| Notes: Source: American Psychological Association, Washington, DC, 1997. [1/1/2007: title modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962469171 | Jeffrey Kearney | Clinical Neuropsychologist | 3812 8th St N Ste 200, Saint Cloud, MN 56303-1421 | 2006-05-01 |
| 1689874539 | Timothy J. Wolfram | Clinical Neuropsychologist | 4801 Veterans Dr, Saint Cloud, MN 56303-2015 | 2007-07-19 |
| 1376614586 | Sandra C. Reese | Clinical Neuropsychologist | 2025 Stearns Way, Suite 111, Saint Cloud, MN 56303-4491 | 2006-11-10 |
| 1588756050 | Nancy Kaye Spitzack | Clinical Neuropsychologist | 4801 Veterans Dr, Saint Cloud, MN 56303-2015 | 2006-09-29 |
| 1679664254 | Wolfram Associates, Ltd. | Clinical Neuropsychologist | 2700 1st St N, Suite 209, Saint Cloud, MN 56303-4256 | 2006-09-27 |
| 1699882217 | Jan L. Holtz | Clinical Neuropsychologist | 1500 Northway Drive, Suite 1, Saint Cloud, MN 56303-1218 | 2006-08-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992302228 | Jsr Neuropsychological Services Pllc | Clinical Neuropsychologist | 3209 W 76th St Ste 207, Edina, MN 55435-5246 | 2020-10-09 |
| 1154942258 | Naomi Nystrom | Clinical Neuropsychologist | Psychology-building A, 3301 7th Ave. N, Anoka, MN 55303 | 2020-04-29 |
| 1013557057 | Erik De Water | Clinical Neuropsychologist | 1876 Minnehaha Ave W, Saint Paul, MN 55104-1029 | 2020-01-07 |
| 1609333038 | Minnesota Neuropsychology, LLC | Clinical Neuropsychologist | 370 Selby Ave Ste 312, Saint Paul, MN 55102-1884 | 2019-02-21 |
| 1285118687 | Chimei M Lee | Clinical Neuropsychologist | 717 Delaware St Se Ste 340, Minneapolis, MN 55414-2959 | 2018-09-20 |
| 1861990012 | Susan Mcpherson Phd Abpp Lp LLC | Clinical Neuropsychologist | 6550 York Ave S Ste 419, Edina, MN 55435-2335 | 2018-01-23 |
| 1609399153 | Sheryl Jayne Pleiss | Clinical Neuropsychologist | 6640 Shady Oak Rd Ste 375, Eden Prairie, MN 55344-7834 | 2017-07-17 |
| 1598204869 | Adam Piccolino | Clinical Neuropsychologist | 11800 Singletree Ln Ste 203, Eden Prairie, MN 55344-5397 | 2017-02-19 |
| 1770832875 | Allen Stock | Clinical Neuropsychologist | 3320 Walnut Grove Ln N, Plymouth, MN 55447-1026 | 2012-09-05 |
| 1962750026 | Paul Marshall LLC | Clinical Neuropsychologist | 825 Nicollet Mall Ste 1440, Medical Arts Bldg, Minneapolis, MN 55402-2718 | 2012-08-21 |
| Find all providers with the same taxonomy | ||||
| City | SAINT CLOUD |
| Zip Code | 56303 |
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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.