Nelson, Bradley Robert
Nelson, Bradley Robert is an individual health care provider with primary practice located at 215 Se 2Nd Ave , Grand Rapids MN 55744-3615. He recently has 3 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Psychologist, Behavioral Health & Social Service Providers / Clinical Child & Adolescent, Behavioral Health & Social Service Providers / Cognitive & Behavioral. Behavioral Health & Social Service Providers / Cognitive & Behavioral is his primary health care specialty. Nelson, Bradley Robert can be contacted via phone (218) 326-1274.Contact Information
Primary practice address
215 Se 2Nd Ave
Grand Rapids MN 55744-3615
Phone: (218) 326-1274
Fax: (218) 326-9787
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Behavioral Health & Social Service Providers / Psychologist | 103T00000X | ||
Behavioral Health & Social Service Providers / Clinical Child & Adolescent | 103TC2200X | ||
Behavioral Health & Social Service Providers / Cognitive & Behavioral | 103TB0200X | LP0590 | Minnesota |
Profile Details
NPI number | 1902822919 |
---|---|
LBN Legal business name | Nelson, Bradley Robert |
Credentials | MALP |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Jul 14th, 2006 |
Last updated | Jan 31st, 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 | 1902822919 | NPPES |
Minnesota | Other | 6275968 | MEDICA |
Minnesota | Other | 160767 | MEDICA |
Minnesota | Other | 3032501 | MEDICA |
Minnesota | Other | 97026 | MEDICA |
Minnesota | MEDICAID | 121052100 | MEDICA |
Minnesota | Other | 4K585NE | MEDICA |
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