TABATHA BRADLEY LAC
NPI 1184468472
Counselor - Professional in Wynne, AR
About Tabatha Bradley Lac NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
TABATHA BRADLEY LAC (NPI 1184468472) is an individual professional provider in Wynne, Arkansas, licensed in Arkansas (P2608004) and active in the NPI registry since June 2024. She is enrolled in Medicare PECOS and is a graduate of Other (2024).
NPPES Registry Identity
Specialties & Licenses 2
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Tabatha Bradley Lac is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignment
Medicare enrollment records show Tabatha Bradley reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Wynne, AR 72396
- Reassigned Medicare billing, Arkansas enrollment
- 26 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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.
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 Tabatha Bradley's NPI number?
The NPI number for Tabatha Bradley is 1184468472. It was assigned to this individual provider in the NPPES registry on June 21, 2024.
Where is Tabatha Bradley located?
Tabatha Bradley practices at 204 Mississippi St S, Wynne, AR 72396. The listed phone number is (870) 208-8499.
What is Tabatha Bradley's specialty?
The primary specialty registered for this NPI is Counselor, specializing in Professional, with taxonomy code 101YP2500X.
Is Tabatha Bradley enrolled in Medicare?
Yes. Tabatha Bradley is registered in the Medicare PECOS enrollment system.
Which organization bills Medicare for Tabatha Bradley's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Tabatha Bradley reassigns Medicare benefits to Changes Behavioral Health, LLC (Wynne, AR). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Tabatha Bradley's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Tabatha Bradley accept?
Health plans from Ambetter Health, Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections, Ambetter from Superior HealthPlan and Ambetter of Oklahoma and 3 other insurers list Tabatha 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 Tabatha Bradley was last updated on August 7, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Tabatha Bradley, LAC · NPI 1184468472
Professional provider in Wynne, Arkansas. Individual provider, active in the CMS NPPES registry since June 21, 2024.
## Identity
- **NPI:** 1184468472 (Entity type: Individual)
- **Enumerated:** June 21, 2024
- **Primary specialty:** Counselor - Professional · taxonomy 101YP2500X
- **State license:** P2608004 (Arkansas)
- **Sole proprietor:** Yes
## Practice location
- **Address:** 204 MISSISSIPPI ST S, Wynne, AR 72396-3025
- **Phone:** (870) 208-8499
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment
- **Bills Medicare through:** Changes Behavioral Health, LLC (NPI 1114260486, Wynne, AR), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2024
## Record status
- **NPPES last updated:** August 7, 2026
---
Source: [NPI Profile](https://npiprofile.com/npi/1184468472) · Data from the CMS NPPES public registry.