Provider Demographics
NPI:1366946766
Name:BRADFORD, BARBARA HUTCHINSON (MASTER OF SOCIAL WOR)
Entity type:Individual
Prefix:
First Name:BARBARA
Middle Name:HUTCHINSON
Last Name:BRADFORD
Suffix:
Gender:F
Credentials:MASTER OF SOCIAL WOR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:644 S 50TH ST
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68510-3809
Mailing Address - Country:US
Mailing Address - Phone:402-314-5702
Mailing Address - Fax:
Practice Address - Street 1:644 S 50TH ST
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68510-3809
Practice Address - Country:US
Practice Address - Phone:402-314-5702
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-20
Last Update Date:2018-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE4589101YM0800X
NE15871041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health