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BRADLEY LODGE
NPI 1922959790
Counselor - Addiction (Substance Use Disorder) in Scotts Valley, CA

Active since February 06, 2026
3192 GLEN CANYON RD, SCOTTS VALLEY, CA 95066(831) 438-1868(831) 438-2789 Get Directions Write a Review

NPPES record last updated: February 6, 2026. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Bradley Lodge NPPES

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

BRADLEY LODGE (NPI 1922959790) is an individual addiction (substance use disorder) provider in Scotts Valley, California, licensed in California (A060541021) and active in the NPI registry since February 2026.

NPPES Registry Identity

NPI1922959790
Entity TypeIndividualMale
Primary Taxonomy101YA0400X
Provider Legal NameBRADLEY LODGE
Location Address3192 GLEN CANYON RDScotts Valley, CA 95066-4916
Mailing Address3600 Glen Canyon RdScotts Valley, CA 95066-4923 · (831) 438-1868 · Fax (831) 438-2789
Phone(831) 438-1868
Fax(831) 438-2789
Sole ProprietorNo
Enumeration DateFebruary 6, 2026
NPPES CertifiedFebruary 6, 2026
✔ NPI 1922959790 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Addiction (Substance Use Disorder)Behavioral Health & Social Service Providers
Taxonomy Code101YA0400X
License✔ Licensed in CA · A060541021
3192 GLEN CANYON RD, Scotts Valley, CA 95066
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Other Providers at the Same Location NPPES 20

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

QUIRINO ORTIZ JR.
Counselor (Addiction (Substance Use Disorder))
3192 GLEN CANYON RD
SCOTTS VALLEY, CA 95066
Santa Cruz County (831) 431-8056
GABRIELLE WHITE RN
Registered Nurse
3192 GLEN CANYON RD
SCOTTS VALLEY, CA 95066
Santa Cruz County (831) 431-8056
LINDA MARIE KERR RN
Registered Nurse (Administrator)
3192 GLEN CANYON RD
SCOTTS VALLEY, CA 95066
Santa Cruz County (831) 269-5578
ROBERT TIMOTHY ERICKSEN
Registered Nurse (Addiction (Substance Use Disorder))
3192 GLEN CANYON RD
SCOTTS VALLEY, CA 95066
Santa Cruz County (831) 226-1214
RUSSELL JOSEPH COWICK MA, AMFT
Marriage & Family Therapist
3192 GLEN CANYON RD
SCOTTS VALLEY, CA 95066
Santa Cruz County (831) 431-8056
SAMANTHA BUSBY
Counselor (Addiction (Substance Use Disorder))
3192 GLEN CANYON RD
SCOTTS VALLEY, CA 95066
Santa Cruz County (831) 431-8056
MR. MICHAEL BERNARD HAME
Registered Nurse (Administrator)
3192 GLEN CANYON RD
SCOTTS VALLEY, CA 95066
Santa Cruz County (831) 430-6918
JEAN BLEVINS
Registered Nurse
3192 GLEN CANYON RD
SCOTTS VALLEY, CA 95066
Santa Cruz County (831) 438-2020

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 Lodge's NPI number?

The NPI number for Bradley Lodge is 1922959790. It was assigned to this individual provider in the NPPES registry on February 6, 2026.

Where is Bradley Lodge located?

Bradley Lodge practices at 3192 Glen Canyon Rd, Scotts Valley, CA 95066. The listed phone number is (831) 438-1868.

What is Bradley Lodge'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 Lodge was last updated on February 6, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 months 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.