Bradbury, Mark L

Bradbury, Mark L is an individual health care provider with primary practice located at 1131 Broadway St , Longview WA 98632-3830. He recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Marriage & Family Therapist, Behavioral Health & Social Service Providers / Counselor. Behavioral Health & Social Service Providers / Counselor is his primary health care specialty. Bradbury, Mark L can be contacted via phone (360) 998-3050.

Contact Information

Primary practice address
1131 Broadway St Longview WA 98632-3830
Phone: (360) 998-3050
Fax: (360) 200-6736
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Marriage & Family Therapist 106H00000X MG61552309 Washington
Behavioral Health & Social Service Providers / Counselor 101Y00000X 61552309 Washington

Profile Details

NPI number 1184312894
LBN Legal business name Bradbury, Mark L
Credentials MA, LMFTA
Entity Individual
Sole proprietor 1 No
Enumeration date May 1st, 2023
Last updated Jul 8th, 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.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1184312894 NPPES
Washington MEDICAID 2243555

Popular Providers