MR. BRADLEY ALLEN SANSOM MS, CADC
Complete NPI Record 1649880170
Marriage & Family Therapist in Paintsville, KY
Active since August 10, 2020
Complete NPI Dataset
This page contains the complete raw NPPES record for Mr. Bradley Allen Sansom, MS, CADC (NPI 1649880170), an individual marriage & family therapist provider in Paintsville, KY. All 34 fields on file are listed with their current values and official NPPES definitions, exactly as recorded in the National Plan and Provider Enumeration System. Only fields that contain data are included, so the number of fields shown varies from one NPI record to another.
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Registry File Document Utilities
- NPI: 1649880170 Field 1/34
- The 10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider. The NPI number includes an ISO standard check-digit in the 10th position. There is no intelligence about the health care provider in the number.
- Entity Type Code: 1 Field 2/34
- Code describing the type of health care provider that is being assigned an NPI. Codes are 1 = (Person): individual human being who furnishes health care; 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
- Provider Last Name Legal Name: SANSOM Field 3/34
- The last name of the provider. If the provider is an individual, this is the legal name.
- Provider First Name: BRADLEY Field 4/34
- The first name of the provider, if the provider is an individual.
- Provider Middle Name: ALLEN Field 5/34
- The middle name of the provider, if the provider is an individual.
- Provider Name Prefix Text: MR. Field 6/34
- The name prefix or salutation of the provider if the provider is an individual; for example, Mr., Mrs., or Corporal.
- Provider Credential Text: MS, CADC Field 7/34
- The abbreviations for professional degrees or credentials used or held by the provider, if the provider is an individual. Examples are MD, DDS, CSW, CNA, AA, NP, RNA, or PSY. These credential designations will not be verified by NPS.
- Provider Other Last Name: SANSOM Field 8/34
- Other last name by which the provider being identified is or has been known.
- Provider Other First Name: BRADLEY Field 9/34
- Other first name by which the provider being identified is or has been known (if an individual). This may be the same as the "Provider first name" if the provider is or has been known by a different last name only.
- Provider Other Middle Name: ALLEN Field 10/34
- Other middle name by which the provider being identified is or has been known (if an individual). This may be the same as the "Provider middle name" if the provider is or has been known by a different last name only.
- Provider Other Name Prefix Text: MR. Field 11/34
- The other name prefix or salutation of the provider if the provider is an individual; for example, Mr., Mrs., or Corporal.
- Provider Other Credential Text: ED.S, M.S, MFTA Field 12/34
- The other abbreviations for professional degrees or credentials used or held by the provider, if the provider is an individual. Examples are MD, DDS, CSW, CNA, AA, NP, RNA, or PSY. These credential designations will not be verified by NPS.
- Provider Other Last Name Type Code: 2 Field 13/34
- Code identifying the type of other name. Codes are: 1 = former name; 2 = professional name; 3 = doing business as (d/b/ a) name; 4 = former legal business name; 5 = other.
- Provider First Line Business Mailing Address: 150 GOBLE BR Field 14/34
- The first line mailing address of the provider being identified. This data element may contain the same information as "Provider first line location address".
- Provider Business Mailing Address City Name: HAGERHILL Field 15/34
- The city name in the mailing address of the provider being identified.
- Provider Business Mailing Address State Name: KY Field 16/34
- The State or Province name in the mailing address of the provider being identified. This data element may contain the same information as "Provider location address State name".
- Provider Business Mailing Address Postal Code: 412228639 Field 17/34
- The postal ZIP or zone code in the mailing address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available. This data element may contain the same information as "Provider location address postal code".
- Provider Business Mailing Address Country Code If outside U S : US Field 18/34
- The country code in the mailing address of the provider being identified. This data element may contain the same information as "Provider location address country code".
- Provider First Line Business Practice Location Address: 628 JEFFERSON AVE Field 19/34
- The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
- Provider Business Practice Location Address City Name: PAINTSVILLE Field 20/34
- The city name in the location address of the provider being identified.
- Provider Business Practice Location Address State Name: KY Field 21/34
- The State code in the location of the provider being identified.
- Provider Business Practice Location Address Postal Code: 412401471 Field 22/34
- The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
- Provider Business Practice Location Address Country Code If outside U S : US Field 23/34
- The country code in the location address of the provider being identified.
- Provider Business Practice Location Address Telephone Number: 6067896966 Field 24/34
- The telephone number associated with the location address of the provider being identified.
- Provider Business Practice Location Address Fax Number: 6067897466 Field 25/34
- The fax number associated with the location address of the provider being identified.
- Provider Gender Code: M Field 28/34
- The code designating the provider's gender if the provider is a person.
- Healthcare Provider Taxonomy Code 1: 106H00000X Field 29/34
- This field represents the provider's taxonomy code, which classifies their type, classification, and area of specialization. This code comes from the Healthcare Provider Taxonomy Code Set maintained by the National Uniform Claim Committee (NUCC). The NPS will associate these data with the license data for providers with Entity type code = 1.
- Provider License Number 1: 283842 Field 30/34
- The license number issued to the provider being identified. The NPS can accommodate multiple license numbers for multiple specialties and for multiple States. The NPS will associate this data element with "provider taxonomy code".
- Provider License Number State Code 1: KY Field 31/34
- The two-letter state code representing the U.S. state or territory that issued the provider's license. This field is linked to the Provider License Number field and identifies the jurisdiction where that license is valid. A provider may have multiple state codes if they hold licenses in more than one state.
- Healthcare Provider Primary Taxonomy Switch 1: Y Field 32/34
- This field shows whether the related taxonomy code is the provider's primary specialty. It is a single-character value: "Y" indicates the taxonomy is the primary one, while "N" indicates it is not. Each provider record can have only one taxonomy code marked as primary.
- Is Sole Proprietor: N Field 33/34
- Indicates whether the provider is registered as a sole proprietor. This is a single-character code: "Y" means the provider operates as a sole proprietor, and "N" means they do not.
Secondary Practice Locations 1
The first line of the secondary practice location address of the provider being identified. For providers with more than one physical location, this is a secondary practice location address. This address cannot include a Post Office box.
150 Goble Br
Location 1/1Hagerhill, KY 41222-8639 · Phone (304) 654-7557
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