BRADLEY CLARK MA LPCC LADC
NPI 1467112342
Counselor - Mental Health in Lindstrom, MN

Q: What is Bradley Clark's NPI number?

The NPI number for Bradley Clark is 1467112342. It was assigned to this individual provider in the NPPES registry on December 20, 2021.

Q: What is Bradley Clark'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 Bradley Clark was last updated on December 20, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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 December 20, 2021

12814 LAKE BLVD, LINDSTROM, MN 55045(651) 755-4276(888) 972-5307 Get Directions Write a Review

NPPES record last updated: December 20, 2021. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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About Bradley Clark Ma Lpcc Ladc NPPES

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

BRADLEY CLARK MA LPCC LADC (NPI 1467112342) is an individual mental health provider in Lindstrom, Minnesota, licensed in Minnesota (3068) and active in the NPI registry since December 2021.

NPPES Registry Identity

NPI1467112342

Entity TypeIndividualMale

Primary Taxonomy101YM0800X

Provider Legal NameBRADLEY CLARKCredential: MA LPCC LADC

Location Address12814 LAKE BLVDLindstrom, MN 55045-9345

Mailing AddressPo Box 974Lindstrom, MN 55045-0974 · (651) 755-4276 · Fax (888) 972-5307

Phone(651) 755-4276

Fax(888) 972-5307

Sole ProprietorYes

Enumeration DateDecember 20, 2021

NPPES CertifiedDecember 20, 2021

✔ NPI 1467112342 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers

Taxonomy Code101YM0800X

License✔ Licensed in MN · 3068

12814 LAKE BLVD, Lindstrom, MN 55045

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Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Other Providers at the Same Location NPPES 2

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

ERIK J. PETERSON CHIROPRACTIC, LLC

Chiropractor

12814 LAKE BLVD
LINDSTROM, MN 55045

Chisago County (651) 233-0594

LAKES AREA CHIROPRACTIC CLINIC LLC

Chiropractor

12814 LAKE BLVD
LINDSTROM, MN 55045

Chisago County (651) 257-3900

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 Clark's NPI number?

The NPI number for Bradley Clark is 1467112342. It was assigned to this individual provider in the NPPES registry on December 20, 2021.

Where is Bradley Clark located?

Bradley Clark practices at 12814 Lake Blvd, Lindstrom, MN 55045. The listed phone number is (651) 755-4276.

What is Bradley Clark's specialty?

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

When was this NPI record last updated?

The NPPES record for Bradley Clark was last updated on December 20, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.