MS. SHARON LEE BONNELLBRADLEY LICSW NPI 1366510307

NPI Information

NPI: 1366510307
Provider Name: MS. SHARON LEE BONNELLBRADLEY, LICSW
Classification: Counselor - 101YM0800X
Entity Type: Individual

Specialization: Mental Health

PECOS Registration: Yes

Address:
84 HIGH ST
SUITE 2B
MEDFORD, MA
ZIP 02155
Phone: (781) 391-1640
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MS. Sharon Lee Bonnellbradley, LICSW is a mental health counselor in Medford, MA with 32 years of experience. MS. Sharon Lee Bonnellbradley, LICSW NPI is 1366510307. 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:

84 HIGH ST
SUITE 2B
MEDFORD, MA
ZIP 02155-844
Phone: (781) 391-1640
Fax: (781) 391-1640

The NPI 1366510307 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment.

The enumeration date for this NPI number is 11/30/2006 and was last updated on 7/9/2007.

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
1	101YM0800X	Counselor	Mental Health	1024763	MASSACHUSETTS	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	003450	OTHER	MASSACHUSETTS	VALUE OPTIONS PROVIDER ID
2	314436	OTHER	MASSACHUSETTS	MBC PROVIDER ID
3	986151	OTHER	MASSACHUSETTS	NETWORK PROVIDER ID
4	P07505	OTHER	MASSACHUSETTS	BCBSPROVIDER ID
5	550010005757	OTHER	MASSACHUSETTS	PACIFICARE PROVIDER ID
6	7925159	OTHER	MASSACHUSETTS	AETNA PROVIDER ID
7	1851489	MEDICAID	MASSACHUSETTS
8	1013390	OTHER	MASSACHUSETTS	BEACON HEALTH STRATEGIES
9	793613	OTHER	MASSACHUSETTS	TUFTS PROVIDER ID
10	003450	OTHER	MASSACHUSETTS	MBHP PROVIDER ID
11	P21070	MEDICARE ID-TYPE UNSPECIFIED	MASSACHUSETTS	PROVIDER ID

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: 4/28/2024

NPI Synchronization or Removal

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