Provider Demographics
NPI:1437841277
Name:BRADFORD, LOIS MARGARET (LPC)
Entity type:Individual
Prefix:
First Name:LOIS
Middle Name:MARGARET
Last Name:BRADFORD
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:LOIS
Other - Middle Name:MARGARET
Other - Last Name:HAMMER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:207 PRECIPICE WAY
Mailing Address - Street 2:
Mailing Address - City:GEORGETOWN
Mailing Address - State:TX
Mailing Address - Zip Code:78626-8162
Mailing Address - Country:US
Mailing Address - Phone:815-761-0431
Mailing Address - Fax:
Practice Address - Street 1:8140 N MOPAC EXPY STE 200
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78759-8837
Practice Address - Country:US
Practice Address - Phone:512-469-0889
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-22
Last Update Date:2023-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX78444101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor