Nelson, Bradley Robert

Nelson, Bradley Robert is an individual health care provider with primary practice located at 215 Se 2Nd Ave , Grand Rapids MN 55744-3615. He recently has 3 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Psychologist, Behavioral Health & Social Service Providers / Clinical Child & Adolescent, Behavioral Health & Social Service Providers / Cognitive & Behavioral. Behavioral Health & Social Service Providers / Cognitive & Behavioral is his primary health care specialty. Nelson, Bradley Robert can be contacted via phone (218) 326-1274.

Contact Information

Primary practice address
215 Se 2Nd Ave Grand Rapids MN 55744-3615
Phone: (218) 326-1274
Fax: (218) 326-9787
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Psychologist 103T00000X
Behavioral Health & Social Service Providers / Clinical Child & Adolescent 103TC2200X
Behavioral Health & Social Service Providers / Cognitive & Behavioral 103TB0200X LP0590 Minnesota

Profile Details

NPI number 1902822919
LBN Legal business name Nelson, Bradley Robert
Credentials MALP
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 14th, 2006
Last updated Jan 31st, 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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Identifiers

StateTypeNumberIssuer
All States NPI 1902822919 NPPES
Minnesota Other 6275968 MEDICA
Minnesota Other 160767 MEDICA
Minnesota Other 3032501 MEDICA
Minnesota Other 97026 MEDICA
Minnesota MEDICAID 121052100 MEDICA
Minnesota Other 4K585NE MEDICA

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