DR. BRIAN WILLIAM BRADLEY (NPI# 1740347608) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1740347608 |
| Entity Type | Individual |
| Full Name | DR. BRIAN WILLIAM BRADLEY |
| Credential | PH.D. |
| Practice Address |
101 Falls Rd Suite 404 Grafton WI 53024-2612 |
| Practice Telephone | 2623758441 |
| Practice Fax Number | 2625460005 |
| Mailing Telephone | 2623758441 |
| Mailing Fax Number | 2625460005 |
| Enumeration Date | 2007-01-02 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TC0700X |
Psychologist Specialization: Clinical |
868 | WI | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | 39050200 | 05 | |
| WI | PSYCHOLOGY LICENSE NUMBER | 868 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104397348 | Brian K Bradley | Counselor | 2212 N Winery Ave, Fresno, CA 93703-2896 | 2018-12-16 |
| 1104474147 | Brian Michael Bradley I | Student in an Organized Health Care Education/Training Program | 340 Maple St, Marlborough, MA 01752-3200 | 2019-09-03 |
| 1184023475 | Brian Bradley | Licensed Practical Nurse | 1400 Blackhorse Hill Rd, Coatesville, PA 19320-2040 | 2014-08-22 |
| 1619384815 | Brian David Bradley | Psychologist | 30200 Telegraph Rd, Suite 207, Bingham Farms, MI 48025-4502 | 2014-07-20 |
| 1124347935 | Brian Sean Bradley | Physical Therapy Assistant | 700 Colorado Blvd, Ste 318, Denver, CO 80206-4084 | 2010-05-19 |
| 1265760029 | Brian Michael Bradley | Specialist/Technologist | 745 Orienta Ave, Suite 1015, Altamonte Springs, FL 32701-5619 | 2009-12-05 |
| 1063590354 | Brian William Bradley | Physical Therapist | 1050 Old Des Peres Rd, Suite 40, Saint Louis, MO 63131-1873 | 2006-11-02 |
| 1881610616 | Brian M. Bradley | Pain Medicine | 401 W Pennsylvania Ave, Anaconda, MT 59711 | 2006-07-14 |
| 1356383269 | Brian A Bradley | Urology | 3605 Executive Dr, San Angelo, TX 76904-6884 | 2006-06-12 |
| 1083611420 | Brian S Bradley | Pediatrics | 2142 N Cove Blvd, Toledo, OH 43606-3895 | 2005-06-30 |
| Street Address |
101 FALLS RD SUITE 404 |
| City | GRAFTON |
| State | WI |
| Zip Code | 53024-2612 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720082175 | William T. Erbes | Dentist | 101 Falls Rd, Ste 500, Grafton, WI 53024-2612 | 2005-06-13 |
| 1497112122 | Kimberly Harrison | Speech-Language Pathologist | 101 Falls Rd, Suite 403, Grafton, WI 53024-2612 | 2016-01-26 |
| 1639554736 | Katie Baud | Counselor | 101 Falls Rd, Suite 403, Grafton, WI 53024-2612 | 2015-07-30 |
| 1144607169 | Ozaukee Community Therapies LLC | Counselor | 101 Falls Rd, Suite 403, Grafton, WI 53024-2612 | 2015-04-28 |
| 1528469855 | Schuckit & Olejniczak Orthodontics, S.c. | Dentist | 101 Falls Rd, Suite 504, Grafton, WI 53024-2612 | 2014-09-05 |
| 1659569705 | Alan L Balkansky Dpm Sc | Clinic/Center | 101 Falls Rd, Suite 600, Grafton, WI 53024-2612 | 2007-10-12 |
| 1578755237 | Adult Child & Family Services LLC | Clinic/Center | 101 Falls Rd, #404, Grafton, WI 53204-2612 | 2007-08-15 |
| 1346312808 | Mary Helen Lillich | Psychologist | 101 Falls Rd, Suite 404, Grafton, WI 53024-2612 | 2006-11-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245739135 | Kathy Anne Herzog | Counselor | 101 Falls Rd Suite 210, Grafton, WI 53024 | 2018-02-06 |
| 1992215867 | Caroline Marie Brandt | Nurse Practitioner | 975 Port Washington Rd Ste 310, Grafton, WI 53024 | 2017-10-05 |
| 1124569181 | Quirt Family Dentistry, Sc | Dentist | 1580 Port Washington Road, Grafton, WI 53024 | 2017-03-10 |
| 1639626260 | Jennifer Pogodzinski | Physical Therapist | 975 N. Port Washington Avenue, Grafton, WI 53024 | 2016-09-01 |
| 1750790119 | Amanda K Olejniczak | Dentist | 1505 Wisconsin Ave, Ste 130, Grafton, WI 53024 | 2014-08-10 |
| 1992053680 | Liliya Lakshtanov | Registered Nurse | 910 E. Paradise Dr., West Bend, WI 53024 | 2012-08-28 |
| 1467708446 | Trevor Holwell | Pharmacist | 1600 N Port Washington Rd, Grafton, WI 53024 | 2012-07-27 |
| 1770838120 | Brian A. Vetterkind | Physical Therapist | 2225 Wisconsin Ave Ste 100, Grafton, WI 53024 | 2012-07-20 |
| 1366774689 | Tracy Lynn Doro-krueger | Counselor | 1814 Arapaho Court, Grafton, WI 53024 | 2010-02-11 |
| 1659507754 | Karen Marie Geschke | Physical Therapist | 2020 Cheyenne Ct., Grafton, WI 53024 | 2009-06-03 |
| Find all providers in zip 53024 | ||||
| Taxonomy Code | 103TC0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376944892 | Michael Russo | Psychologist | 2500 Avon Belden Rd, Grafton, OH 44044-9802 | 2014-09-16 |
| 1144505231 | Heidi Jo Madsen | Psychologist | 701 W 6th St, Grafton, ND 58237-1379 | 2011-10-20 |
| 1265576680 | Paul Douglas Kolstoe | Psychologist | 701 W 6th St, Grafton, ND 58237-1379 | 2007-02-18 |
| 1427152529 | Glenn D Shean | Psychologist | 6515 George Washington Mem Hwy, Ste 100, Grafton, VA 23692-2182 | 2006-09-11 |
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|---|---|---|---|---|
| 1881295863 | Emotive Action Counseling Services LLC | Psychologist | 9235 W Capitol Dr Ste 402, Milwaukee, WI 53222-1567 | 2020-11-05 |
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| 1487283669 | Maria Gambaro | Psychologist | W4557 Gillette Dr, Montello, WI 53949-8951 | 2020-04-08 |
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| 1871138115 | Point Counseling Center LLC | Psychologist | 1547 Strongs Ave Ste D, Stevens Point, WI 54481-3566 | 2019-11-11 |
| 1508417916 | Cassandra D Pasquariello | Psychologist | Department of Athletics, 1440 Monroe Street, Madison, WI 53711 | 2019-09-26 |
| 1023673563 | Robert E Young | Psychologist | 735 N Water St Ste 712, Milwaukee, WI 53202-4104 | 2019-05-09 |
| 1346705951 | Joseph John Abhold | Psychologist | 402 Graham Ave Ste 208, Eau Claire, WI 54701-2633 | 2019-02-07 |
| 1972075661 | Moonlight Psychotherapy and Psychological Services, LLC | Psychologist | 205 5th Ave S Ste 428, La Crosse, WI 54601-4059 | 2018-12-19 |
| Find all providers with the same taxonomy | ||||
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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.