DR. ROLLA MERLE BRADLEY JR. PH.D, LPC-S - NPI 1063765246

Q: What is Rolla Bradley's NPI number?

The NPI number for Rolla Bradley is 1063765246. It was assigned to this individual provider in the NPPES registry on October 25, 2012.

Q: What is Rolla Bradley's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.

Q: When was this NPI record last updated?

The NPPES record for Rolla Bradley was last updated on May 2, 2024. NPI Profile syncs with the weekly NPPES data releases published by CMS.

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About Dr. Rolla Merle Bradley Jr. Ph.d, Lpc-s NPPES

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

DR. ROLLA MERLE BRADLEY JR. PH.D, LPC-S (NPI 1063765246) is an individual mental health provider in Denton, Texas, licensed in Texas (14527) and active in the NPI registry since October 2012. He is enrolled in Medicare PECOS and maintains a secondary practice location in Friendswood.

NPPES Registry Identity

NPI1063765246

Entity TypeIndividualMale

Primary Taxonomy101YM0800X

Provider Legal NameDR. ROLLA MERLE BRADLEY JR.Credential: PH.D, LPC-S

Location Address303 N CARROLL BLVD STE 114Denton, TX 76201-9075

Mailing Address308 S Friendswood Dr Ste 200Friendswood, TX 77546-3989 · (844) 824-8775

Phone(844) 824-8775

Sole ProprietorNo

Enumeration DateOctober 25, 2012

Last NPPES UpdateMay 2, 20243 updates tracked since enumeration

NPPES CertifiedMay 2, 2024

✔ NPI 1063765246 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 4

★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers

Taxonomy Code101YM0800X

License✔ Licensed in TX · 14527

Also ListedCounselor · PastoralTaxonomy 101YP1600X · License 14527 (TX)

Also ListedCounselor · ProfessionalTaxonomy 101YP2500X · License 14527 (TX)

Also ListedCounselor · SchoolTaxonomy 101YS0200X · License 14527 (TX)

303 N CARROLL BLVD STE 114, Denton, TX 76201

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Secondary Practice Location 1

Location 1308 S Friendswood Dr Ste 200Friendswood, TX 77546-3989 · Phone (844) 824-8775

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Baylor Scott and White Health Plan, Blue Cross and Blue Shield of Texas, 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)

Dr. Rolla Merle Bradley Jr. Ph.d, Lpc-s 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.

Other Providers at the Same Location NPPES 9

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

KEYALLA CHEYENNE MILLER LPC-ASSOCIATE

Counselor (Mental Health)