TABATHA BRADLEY LAC NPI 1184468472

NPI Information

  • NPI: 1184468472
  • Provider Name: TABATHA BRADLEY, LAC
  • Classification: Counselor - 101Y00000X
  • Entity Type: Individual
  • Address: 204 MISSISSIPPI ST S
    WYNNE, AR
    ZIP 72396
  • Phone: (870) 208-8499

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NPI Details

Tabatha Bradley, LAC is a counselor in Wynne, AR. The provider is a provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master's degree and clinical experience and supervision for licensure or certification. Tabatha Bradley, LAC NPI is 1184468472. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

204 MISSISSIPPI ST S
WYNNE, AR
ZIP 72396-025
Phone: (870) 208-8499

The enumeration date for this NPI number is 6/21/2024 and was last updated on 6/21/2024.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1101Y00000XCounselorA2406004ARKANSASYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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