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DATRESE MONIQUE BRADLEY LCPC
NPI 1053059949
Counselor - Professional in Carbondale, IL

Active since May 22, 2022PECOS Enrolled
103 N ROD LN, CARBONDALE, IL 62901(618) 203-6925 Get Directions Write a Review

NPPES record last updated: May 22, 2022. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Datrese Monique Bradley Lcpc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DATRESE MONIQUE BRADLEY LCPC (NPI 1053059949) is an individual professional provider in Carbondale, Illinois, licensed in Illinois (180.014457) and active in the NPI registry since May 2022. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1053059949
Entity TypeIndividualFemale
Primary Taxonomy101YP2500X
Provider Legal NameDATRESE MONIQUE BRADLEYCredential: LCPC
Location Address103 N ROD LNCarbondale, IL 62901-2031
Mailing Address103 N Rod LnCarbondale, IL 62901-2031 · (618) 203-6925
Phone(618) 203-6925
Sole ProprietorYes
Enumeration DateMay 22, 2022
NPPES CertifiedMay 22, 2022
✔ NPI 1053059949 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · ProfessionalBehavioral Health & Social Service Providers
Taxonomy Code101YP2500X
License✔ Licensed in IL · 180.014457
103 N ROD LN, Carbondale, IL 62901
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X MULTIPLE SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include UnitedHealthcare.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Datrese Monique Bradley Lcpc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Datrese Bradley's NPI number?

The NPI number for Datrese Bradley is 1053059949. It was assigned to this individual provider in the NPPES registry on May 22, 2022.

Where is Datrese Bradley located?

Datrese Bradley practices at 103 N Rod Ln, Carbondale, IL 62901. The listed phone number is (618) 203-6925.

What is Datrese Bradley's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Professional, with taxonomy code 101YP2500X.

Is Datrese Bradley enrolled in Medicare?

Yes. Datrese Bradley is registered in the Medicare PECOS enrollment system.

What insurance does Datrese Bradley accept?

Health plans from UnitedHealthcare list Datrese Bradley as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Datrese Bradley was last updated on May 22, 2022. NPI Profile syncs with the weekly NPPES data releases published by CMS.