Crenshaw, Bradley John

Crenshaw, Bradley John is an individual health care provider with primary practice located at 79 S Pleasant St Suite 6, Amherst MA 01002-2370. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical Neuropsychologist, which is considered as his primary health care specialty. Crenshaw, Bradley John can be contacted via phone (413) 259-1017.

Contact Information

Primary practice address
79 S Pleasant St Suite 6 Amherst MA 01002-2370
Phone: (413) 259-1017
Fax: (413) 259-1017
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical Neuropsychologist 103G00000X 6679 Massachusetts

Profile Details

NPI number 1215994207
LBN Legal business name Crenshaw, Bradley John
Credentials PH.D.
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 26th, 2006
Last updated Dec 12th, 2008 - about 17 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 1215994207 NPPES
Massachusetts MEDICAID 0526886
Massachusetts Other 24757
Massachusetts Other W05830
Massachusetts Other 62000574

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