LARRY MILES BRADLEY LCSW - NPI 1891139432 - Social Worker in Saint Anthony, ID

Q: What is Larry Bradley's NPI number?

The NPI number for Larry Bradley is 1891139432. It was assigned to this individual provider in the NPPES registry on April 25, 2013.

Q: What is Larry Bradley's specialty?

The primary specialty registered for this NPI is Social Worker, specializing in Clinical, with taxonomy code 1041C0700X.

Q: When was this NPI record last updated?

The NPPES record for Larry Bradley was last updated on June 3, 2024. NPI Profile syncs with the weekly NPPES data releases published by CMS.

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About Larry Miles Bradley Lcsw NPPES

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

LARRY MILES BRADLEY LCSW (NPI 1891139432) is an individual clinical provider in Saint Anthony, Idaho, licensed in Idaho (LCSW 30350) and active in the NPI registry since April 2013. He is enrolled in Medicare PECOS, maintains 2 additional practice locations, and is a graduate of Other (2006).

NPPES Registry Identity

NPI1891139432

Entity TypeIndividualMale

Primary Taxonomy1041C0700X

Provider Legal NameLARRY MILES BRADLEYCredential: LCSW

Location Address335 E MAIN ST STE 1Saint Anthony, ID 83445-1546

Mailing AddressPo Box 18Saint Anthony, ID 83445-0018 · (208) 356-4900 · Fax (208) 624-4112

Phone(208) 356-4900

Fax(208) 624-4030

Sole ProprietorNo

Medical School CMSOtherGraduated 2006

Enumeration DateApril 25, 2013

Last NPPES UpdateJune 3, 20246 updates tracked since enumeration

NPPES CertifiedJune 3, 2024

✔ NPI 1891139432 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers

Taxonomy Code1041C0700X

License✔ Licensed in ID · LCSW 30350

Definition

A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances.

335 E MAIN ST STE 1, Saint Anthony, ID 83445

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Secondary Practice Locations 2

Location 172 S 1st E Ste 101Rexburg, ID 83440-1965 · Phone (208) 356-4900 · Fax (208) 624-4030

Location 23729 Woodking Dr Ste 1Idaho Falls, ID 83404-4720 · Phone (208) 356-4900 · Fax (208) 612-6118

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Moda Health Plan, Inc., PacificSource Health Plans, Select Health and more.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Larry Miles Bradley Lcsw is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID1153686209

PECOS Enrollment IDI20180521002199

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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 83445 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$0.00 typical visit price

range $52.44 – $160.17

Typical copayment $0.00 (range $13.11 – $40.04)

Most-billed visit code NA

Established Patient

$65.77 typical visit price

range $16.68 – $130.93

Typical copayment $16.44 (range $4.17 – $32.73)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 9

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

MINDY JENSEN LCSW

Social Worker (Clinical)