Provider Demographics
NPI:1447653860
Name:BRADLEY, RHONDA (LPC)
Entity type:Individual
Prefix:
First Name:RHONDA
Middle Name:
Last Name:BRADLEY
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 S QUAKER LN
Mailing Address - Street 2:SUITE 210
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22314-4583
Mailing Address - Country:US
Mailing Address - Phone:517-392-5536
Mailing Address - Fax:
Practice Address - Street 1:20 S QUAKER LN
Practice Address - Street 2:SUITE 210
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22314-4583
Practice Address - Country:US
Practice Address - Phone:517-392-5536
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-30
Last Update Date:2014-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI64010100005101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional