CRYSTAL LYNN BRADFORD (NPI# 1366080533) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1366080533 |
Entity Type | Individual |
Full Name | CRYSTAL LYNN BRADFORD |
Practice Address |
21770 Fdr Blvd. Lexington Park MD 20653 |
Mailing Address |
325 Williams Rd Prince Frederick MD 20678-3541 |
Practice Telephone | 3019971300 |
Practice Fax Number | 3018669182 |
Mailing Telephone | 4436848320 |
Enumeration Date | 2019-12-18 |
Last Update Date | 2019-12-18 |
Gender Code | F |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
Behavioral Health & Social Service Providers |
Street Address |
21770 FDR BLVD. |
City | LEXINGTON PARK |
State | MD |
Zip Code | 20653 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1386258929 | Suzette Jones | Nurse Practitioner | Chesapeake Shores Nursing Home, 21412 Great Mills Road, Lexington Park, MD 20653 | 2020-09-01 |
1659910214 | Shannon Dawn Morley | Family Medicine | 45870 E Run Dr, Lexington Park, MD 20653 | 2019-12-31 |
1205487584 | Paulette Tyrone Scriber | Technician | 20286 Scriber Ln, Lexington Park, MD 20653 | 2019-09-26 |
1073162103 | Bambii Kreal | Counselor | 21770 Franklin Delano Roosevelt Blvd, Lexington Park, MD 20653 | 2019-09-11 |
1376039479 | Arianna Marie Day | Social Worker | 21789 N Coral Drive - Ste 2a, Bowes and Associates Psychotherapy LLC, Lexington Park, MD 20653 | 2018-07-02 |
1982032694 | Trico Clinical Services, Ltd | Clinic/Center | 46707 S. Shangri La Drive, Lexington Park, MD 20653 | 2013-10-16 |
1891047726 | Axis Healthcare Group | Social Worker | 45870 East Run Drive, Lexington Park, MD 20653 | 2012-10-02 |
1013164466 | Denise Owens Mullinix | Dentist | 22749 Maple Road, Lexington Park, MD 20653 | 2008-08-27 |
1548440555 | Trico Clinical Services, Ltd | Counselor | 46940 S. Shangri La Drive, Lexington Park, MD 20653 | 2007-11-07 |
1578761425 | Shah Associates Md LLC | Internal Medicine | Lexington Park Medical Center, 22335 Exploration Park, Lexington Park, MD 20653 | 2007-07-03 |
Find all providers in zip 20653 |
Taxonomy Code | 101YA0400X |
Grouping | Behavioral Health & Social Service Providers |
Classification | Counselor |
Specialization | Addiction (Substance Use Disorder) |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1073162103 | Bambii Kreal | Counselor | 21770 Franklin Delano Roosevelt Blvd, Lexington Park, MD 20653 | 2019-09-11 |
1619007143 | Sarah Anne Crowder | Counselor | 21641 Great Mills Rd, Lexington Park, MD 20653-1239 | 2007-03-06 |
1285266510 | Kim Ureka Sollers | Counselor | 21770 Franklin Delano Roosevelt Blvd, Lexington Park, MD 20653 | 2020-02-05 |
1285272351 | Samone Bond | Counselor | 21770 Fdr Blvd, Lexington Park, MD 20653 | 2019-12-19 |
1366961955 | Melissa Evonne Fletcher | Counselor | 21770 Fdr Blvd, Lexington Park, MD 20653 | 2017-09-14 |
1639537772 | Debra Corine Flerlage | Counselor | 21789 N Coral Dr, Lexington Park, MD 20653-5517 | 2016-02-03 |
1790080711 | Veronica Gonzalez | Counselor | 21641 Great Mills Rd, Lexington Park, MD 20653-1239 | 2011-01-22 |
1184954745 | Pyramid Walden, LLC | Counselor | 21770 Fdr Blvd, Lexington Park, MD 20653-1558 | 2010-01-05 |
1295708261 | Philippe Cj Denis | Counselor | 21770 Fdr Blvd, Lexington Park, MD 20653 | 2006-02-09 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1861091522 | Choices Integrated Healthcare | Counselor | 1600 Bush St, Baltimore, MD 21230-2021 | 2020-10-22 |
1831706068 | James Simmons | Counselor | 975 Solomons Island Rd N # 119, Prince Frederick, MD 20678-3917 | 2020-10-01 |
1730791609 | Tony C Shaw | Counselor | 2814 W Garrison Ave, Baltimore, MD 21215-5335 | 2020-08-20 |
1134739600 | Crystal Yolanda Mason | Counselor | 10006 Antium Way, Owings Mills, MD 21117-4069 | 2020-08-08 |
1023628849 | Delores Jordan | Counselor | 2640 Oswego Ave, Baltimore, MD 21215-7037 | 2020-08-06 |
1588274773 | Positive Reinforcements Inc. | Counselor | 30260 Mount Vernon Rd Unit 6, Princess Anne, MD 21853-2202 | 2020-08-03 |
1073122511 | Rasheed Badmus | Counselor | 46 Solar Cir Apt A, Parkville, MD 21234-6831 | 2020-07-30 |
1144838277 | Guiding Lives | Counselor | 6305 Belair Rd, Baltimore, MD 21206-1817 | 2020-07-15 |
1750908943 | New Life Services LLC. | Counselor | 3600 W Mulberry St, Baltimore, MD 21229-2928 | 2020-07-03 |
1801413422 | Karena Tinika Lee | Counselor | 1336 Homestead St, Baltimore, MD 21218-3624 | 2020-06-30 |
Find all providers with the same taxonomy |
City | LEXINGTON PARK |
Zip Code | 20653 |
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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.