Bradshaw, Susan L
Bradshaw, Susan L is an sole proprietor health care provider with primary practice located at 3790 Old Us 41 N Ste A , Valdosta GA 31602-6865. She recently has only one registered license in Behavioral Health & Social Service Providers / Marriage & Family Therapist, which is considered as her primary health care specialty. Bradshaw, Susan L can be contacted via phone (229) 262-1000.Contact Information
Primary practice address
3790 Old Us 41 N Ste A
Valdosta GA 31602-6865
Phone: (229) 262-1000
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Marriage & Family Therapist | 106H00000X | 000865 | Georgia |
Profile Details
| NPI number | 1154339422 |
|---|---|
| LBN Legal business name | Bradshaw, Susan L |
| Credentials | Licensed Clinical Social Worker (LCSW) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Aug 3rd, 2006 |
| Last updated | Mar 4th, 2024 - about 8 months 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1154339422 | NPPES |
| Georgia | MEDICAID | 592486097A |
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