ANGELIA PINCKARD BRADLEY (NPI# 1982708665) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1982708665 |
| Entity Type | Individual |
| Full Name | ANGELIA PINCKARD BRADLEY |
| Credential | MED LPC MHSP |
| Practice Address |
210 Joe Hale Dr Johnson City TN 37615-3866 |
| Practice Telephone | 4236777824 |
| Mailing Telephone | 4236777824 |
| Enumeration Date | 2006-09-12 |
| Last Update Date | 2016-09-15 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YP2500X |
Counselor Specialization: Professional |
LPCMHSP2004 | TN | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MAGELLAN NAVIGATOR | 4120940 | 01 | |
| INITIAL GROUP GROUP | 620582605 | 01 | |
| THREE RIVERS PROVI GROUP | 620582605 | 01 | |
| MAGELLAN SUMMIT | 4120940 | 01 | |
| CORPHEALTH | 620582605 | 01 | |
| MAGELLAN PINNACLE | 4120940 | 01 | |
| CARITEN PHP PPO | 620582605 | 01 | |
| CARITEN PHP HMO | 620582605 | 01 | |
| CARITEN PHP WORKCO | 620582605 | 01 | |
| CARITEN SENIOR PPO | 620582605 | 01 | |
| CARITEN SENIOR HMO | 620582605 | 01 | |
| VIRGINIA MEDICAID CTC | 010277582 | 01 | |
| TRICARE SOUTH | 620582605 | 01 | |
| PHCS | 9427660 | 01 | |
| VALUEOPTIONS GROUP | 334969 | 01 | |
| CARITEN PHP POS | 620582605 | 01 | |
| CARITEN PPO LEASE | 620582605 | 01 |
| Street Address |
210 JOE HALE DR |
| City | JOHNSON CITY |
| State | TN |
| Zip Code | 37615-3866 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568962983 | Clayton Kilgore | Pharmacist | 208 Suncrest St Unit 1, Gray, TN 37615 | 2018-02-13 |
| 1346648268 | Jesse Mullins | Pharmacist | 121 Boone Ridge Dr, Suite 1006, Johnson City, TN 37615 | 2014-12-09 |
| 1750650875 | Medical Education Assistance Corporation | Pediatrics | 252 Sam Jenkins Rd, Attn: Dr. H. Patrick Stern, Gray, TN 37615 | 2011-12-19 |
| 1700018603 | Anna Lynne Deal | Nurse Practitioner | 119 Boone Ridge Dr., Ste. 201, Johnson City, TN 37615 | 2009-08-11 |
| 1285876631 | Leigh A Furman | Occupational Therapist | 253 Wiltshire Dr., Gray, TN 37615 | 2009-04-01 |
| 1811098908 | Fay Lynn Bembry | Nurse Practitioner | 119 Boone Ridge Drive Ste. 201, Johnson City, TN 37615 | 2006-09-25 |
| 1871528976 | Boones Creek Medical Pllc | Family Medicine | 2685 Boones Creek Road, Suite 104, Johnson City, TN 37615 | 2006-07-11 |
| 1568402048 | Joseph Vincent Pinyard Jr. | Family Medicine | 880 Boones Station Rd, Johnson City, TN 37615 | 2006-06-07 |
| 1548223084 | Pitchar Theerathorn | Internal Medicine | 119 Boone Ridge Drive, Suite 201, Johnson City, TN 37615 | 2006-04-07 |
| 1194717157 | Susan Kay Pennypacker | Nurse Practitioner | 140 Old Gray Station Rd, Suite 200, Gray, TN 37615 | 2005-08-16 |
| Find all providers in zip 37615 | ||||
| Taxonomy Code | 101YP2500X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Professional |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801497508 | Emily Hand | Counselor | 1200 Southwest Ave, Johnson City, TN 37604-6520 | 2020-11-08 |
| 1447860192 | Kasey Smith | Counselor | 2349 Ranch Road 1323, Johnson City, TX 78636-4787 | 2020-08-07 |
| 1912547142 | David Earl Ramsey | Counselor | 170 Frank Humphreys Ln, Johnson City, TN 37601-3637 | 2020-01-15 |
| 1003329517 | Summit Counseling Services LLC | Counselor | 4132 Bristol Hwy Ste 5, Johnson City, TN 37601-3162 | 2017-11-07 |
| 1952642811 | Cathaleen Lynn Blake | Counselor | 2700 S Roan St Ste 203, Johnson City, TN 37601-7557 | 2013-03-01 |
| 1609101575 | Mary E Marley | Counselor | 2700 S Roan St Ste 400, Johnson City, TN 37601-7678 | 2009-10-12 |
| 1811141344 | Tonya L. Mckoy | Counselor | 1735 W State of Franklin Rd # 5-227, Johnson City, TN 37604-6573 | 2008-11-11 |
| 1346415254 | Danny Kellum | Counselor | 2722 E Oakland Ave, Johnson City, TN 37601-1844 | 2008-04-23 |
| 1487847091 | Artemis Enrichment & Learning Center, LLC | Counselor | 112 East Myrtle Avenue, Suite 408, Johnson City, TN 37601 | 2007-08-27 |
| 1174674725 | Rose M Shea | Counselor | 420 Ivy Pl, Johnson City, NY 13790-4933 | 2007-01-12 |
| Find all providers in JOHNSON CITY | ||||
| City | JOHNSON CITY |
| Zip Code | 37615 |
Please comment or provide details below to improve the information on ANGELIA PINCKARD BRADLEY.
| 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.