Provider Demographics
NPI:1629568027
Name:BRADSHAW COUNSELING AND CONSULTATION SERVICES LLC
Entity type:Organization
Organization Name:BRADSHAW COUNSELING AND CONSULTATION SERVICES LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRACTICE ADMINISTRATOR/CO-FOUNDER
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMIE
Authorized Official - Middle Name:J
Authorized Official - Last Name:BRADSHAW
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:870-376-2838
Mailing Address - Street 1:405 W ARCH AVE
Mailing Address - Street 2:
Mailing Address - City:SEARCY
Mailing Address - State:AR
Mailing Address - Zip Code:72143-5202
Mailing Address - Country:US
Mailing Address - Phone:870-376-2838
Mailing Address - Fax:510-305-0189
Practice Address - Street 1:1141 E MAIN ST STE 200
Practice Address - Street 2:
Practice Address - City:BATESVILLE
Practice Address - State:AR
Practice Address - Zip Code:72501-3014
Practice Address - Country:US
Practice Address - Phone:870-376-2838
Practice Address - Fax:501-305-0189
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-05-11
Last Update Date:2025-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty