Provider Demographics
NPI:1841177052
Name:BRADFORD, NICOLE HAYS (MSW, ASW)
Entity type:Individual
Prefix:
First Name:NICOLE
Middle Name:HAYS
Last Name:BRADFORD
Suffix:
Gender:F
Credentials:MSW, ASW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2362
Mailing Address - Street 2:
Mailing Address - City:WEAVERVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:96093-2362
Mailing Address - Country:US
Mailing Address - Phone:530-739-2216
Mailing Address - Fax:
Practice Address - Street 1:PO BOX 1256
Practice Address - Street 2:
Practice Address - City:WEAVERVILLE
Practice Address - State:CA
Practice Address - Zip Code:96093-1256
Practice Address - Country:US
Practice Address - Phone:530-623-2861
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-19
Last Update Date:2025-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA114875101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health