Bradley, Derrick

Bradley, Derrick is an sole proprietor health care provider with primary practice located at 3265 Highway 26 , Corbin KY 40701-9047. He recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), Behavioral Health & Social Service Providers / Professional. Behavioral Health & Social Service Providers / Professional is his primary health care specialty. Bradley, Derrick can be contacted via phone (606) 555-1212.

Contact Information

Primary practice address
3265 Highway 26 Corbin KY 40701-9047
Phone: (606) 555-1212
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X 167193 Kentucky
Behavioral Health & Social Service Providers / Professional 101YP2500X 104136 Kentucky

Profile Details

NPI number 1164284550
LBN Legal business name Bradley, Derrick
Credentials LPCC-S, LCADC
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jan 30th, 2024
Last updated Jan 30th, 2024 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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