MR. BRADLEY KEBODEAUX LPC
NPI 1447577002
Counselor - Professional in Booneville, MS

Q: What is Bradley Kebodeaux's NPI number?

The NPI number for Bradley Kebodeaux is 1447577002. It was assigned to this individual provider in the NPPES registry on April 22, 2010.

Q: What is Bradley Kebodeaux's specialty?

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

Q: When was this NPI record last updated?

The NPPES record for Bradley Kebodeaux was last updated on August 26, 2016. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since April 22, 2010PECOS Enrolled

2100 E CHAMBERS DR, BOONEVILLE, MS 38829(662) 728-3174(662) 728-3175 Get Directions Write a Review

NPPES record last updated: August 26, 2016. Verified against the NPPES registry weekly; last sync: July 26, 2026.

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About Mr. Bradley Kebodeaux Lpc NPPES

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

MR. BRADLEY KEBODEAUX LPC (NPI 1447577002) is an individual professional provider in Booneville, Mississippi, licensed in Mississippi (1633) and active in the NPI registry since April 2010. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1447577002

Entity TypeIndividualMale

Primary Taxonomy101YP2500X

Provider Legal NameMR. BRADLEY KEBODEAUXCredential: LPC

Location Address2100 E CHAMBERS DRBooneville, MS 38829-8938

Mailing Address303 N Madison StCorinth, MS 38834-5072 · (662) 286-9883 · Fax (662) 286-8095

Phone(662) 728-3174

Fax(662) 728-3175

Sole ProprietorYes

Enumeration DateApril 22, 2010

Last NPPES UpdateAugust 26, 2016

✔ NPI 1447577002 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyCounselor · ProfessionalBehavioral Health & Social Service Providers

Taxonomy Code101YP2500X

License✔ Licensed in MS · 1633

Also ListedCounselor · Mental HealthTaxonomy 101YM0800X

2100 E CHAMBERS DR, Booneville, MS 38829

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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mr. Bradley Kebodeaux Lpc 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 13

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

KATHRYN GANN MURFF MS

Counselor (Mental Health)