Carroll, John Bradley
Carroll, John Bradley is an sole proprietor health care provider with primary practice located at 31500 W 13 Mile Rd #111, Farmington Hills MI 48334-2164. He recently has 3 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Clinical Neuropsychologist, Behavioral Health & Social Service Providers / Clinical, Behavioral Health & Social Service Providers / Clinical Child & Adolescent. Behavioral Health & Social Service Providers / Clinical Child & Adolescent is his primary health care specialty. Carroll, John Bradley can be contacted via phone (248) 855-9220.Contact Information
Primary practice address
31500 W 13 Mile Rd #111
Farmington Hills MI 48334-2164
Phone: (248) 855-9220
Fax: (248) 855-3866
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical Neuropsychologist | 103G00000X | ||
| Behavioral Health & Social Service Providers / Clinical | 103TC0700X | 6301007077 | Michigan |
| Behavioral Health & Social Service Providers / Clinical Child & Adolescent | 103TC2200X |
Profile Details
| NPI number | 1952549891 |
|---|---|
| LBN Legal business name | Carroll, John Bradley |
| Credentials | PH.D. |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jan 30th, 2009 |
| Last updated | Jan 30th, 2009 - about 15 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1952549891 | NPPES |
| Michigan | Other | 68-0-F3-3086-0 | BCBS OF MICHIGAN |
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