Bradley, Melissa Louise

Bradley, Melissa Louise is an individual health care provider with primary practice located at 350 Salem Rd Ste 1 , Conway AR 72034-6166. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Mental Health, Behavioral Health & Social Service Providers / Professional. Behavioral Health & Social Service Providers / Professional is her primary health care specialty. Bradley, Melissa Louise can be contacted via phone (501) 336-8300.

Contact Information

Primary practice address
350 Salem Rd Ste 1 Conway AR 72034-6166
Fax: (501) 329-5508
Website:

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Mental Health 101YM0800X P2001007 Arkansas
Behavioral Health & Social Service Providers / Professional 101YP2500X P2001007 Arkansas

Profile Details

NPI number 1518113463
LBN Legal business name Bradley, Melissa Louise
Credentials Licensed Professional Counselor (LPC)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 12th, 2008
Last updated Apr 21st, 2020 - about 5 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 1518113463 NPPES
Arkansas MEDICAID 238094719

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