MR. BRADLEY A GANGNON LADC, ADCR-MN CPRS
NPI 1225715097
Counselor - Addiction (Substance Use Disorder) in Minneapolis, MN

Q: What is Bradley Gangnon's NPI number?

The NPI number for Bradley Gangnon is 1225715097. It was assigned to this individual provider in the NPPES registry on July 3, 2023.

Q: What is Bradley Gangnon's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Addiction (Substance Use Disorder), with taxonomy code 101YA0400X.

Q: When was this NPI record last updated?

The NPPES record for Bradley Gangnon was last updated on July 3, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years 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.

Active since July 03, 2023

1516 W LAKE ST # 205, MINNEAPOLIS, MN 55408(612) 297-1804 Get Directions Write a Review

NPPES record last updated: July 3, 2023. Verified against the NPPES registry weekly; last sync: August 16, 2026.

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About Mr. Bradley A Gangnon Ladc, Adcr-mn Cprs NPPES

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

MR. BRADLEY A GANGNON LADC, ADCR-MN CPRS (NPI 1225715097) is an individual addiction (substance use disorder) provider in Minneapolis, Minnesota, licensed in Minnesota (305379) and active in the NPI registry since July 2023.

NPPES Registry Identity

NPI1225715097

Entity TypeIndividualMale

Primary Taxonomy101YA0400X

Provider Legal NameMR. BRADLEY A GANGNONCredential: LADC, ADCR-MN CPRS

Location Address1516 W LAKE ST # 205Minneapolis, MN 55408-2554

Mailing Address1516 W Lake St # 205Minneapolis, MN 55408-2554 · (612) 297-1804

Phone(612) 297-1804

Sole ProprietorNo

Enumeration DateJuly 3, 2023

NPPES CertifiedApril 10, 2022

✔ NPI 1225715097 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyCounselor · Addiction (Substance Use Disorder)Behavioral Health & Social Service Providers

Taxonomy Code101YA0400X

License✔ Licensed in MN · 305379

Also ListedRehabilitation PractitionerTaxonomy 225400000X · License 10053940

1516 W LAKE ST # 205, Minneapolis, MN 55408

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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 Bradley Gangnon's NPI number?

The NPI number for Bradley Gangnon is 1225715097. It was assigned to this individual provider in the NPPES registry on July 3, 2023.

Where is Bradley Gangnon located?

Bradley Gangnon practices at 1516 W Lake St # 205, Minneapolis, MN 55408. The listed phone number is (612) 297-1804.

What is Bradley Gangnon's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Addiction (Substance Use Disorder), with taxonomy code 101YA0400X.

When was this NPI record last updated?

The NPPES record for Bradley Gangnon was last updated on July 3, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years 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.