JEWELL DOUGLAS BRADFORD - NPI 1063136570 - Peer Specialist in Wasilla, AK

Q: What is Jewell Bradford's NPI number?

The NPI number for Jewell Bradford is 1063136570. It was assigned to this individual provider in the NPPES registry on September 28, 2022.

Q: What is Jewell Bradford's specialty?

The primary specialty registered for this NPI is Peer Specialist with taxonomy code 175T00000X.

Q: When was this NPI record last updated?

The NPPES record for Jewell Bradford was last updated on September 28, 2022. NPI Profile syncs with the weekly NPPES data releases published by CMS.

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About Jewell Douglas Bradford NPPES

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

JEWELL DOUGLAS BRADFORD (NPI 1063136570) is an individual peer specialist in Wasilla, Alaska and active in the NPI registry since September 2022.

NPPES Registry Identity

NPI1063136570

Entity TypeIndividualMale

Primary Taxonomy175T00000X

Provider Legal NameJEWELL DOUGLAS BRADFORD

Location Address1363 W SPRUCE AVEWasilla, AK 99654-5327

Mailing AddressPo Box 870591Wasilla, AK 99687-0591 · (907) 671-3338

Phone(907) 376-2411

Sole ProprietorNo

Enumeration DateSeptember 28, 2022

NPPES CertifiedSeptember 28, 2022

✔ NPI 1063136570 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPeer SpecialistOther Service Providers

Taxonomy Code175T00000X

Definition

Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority.

1363 W SPRUCE AVE, Wasilla, AK 99654

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Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

PARIS TAYLOR LCSW-C

Counselor (Mental Health)