Provider Demographics
NPI:1841313046
Name:BRADLEY, DENNIS ANTHONY SR (PSYCHOTHERAPIST)
Entity type:Individual
Prefix:
First Name:DENNIS
Middle Name:ANTHONY
Last Name:BRADLEY
Suffix:SR
Gender:M
Credentials:PSYCHOTHERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:671 RIVER ST
Mailing Address - Street 2:
Mailing Address - City:WINCHENDON
Mailing Address - State:MA
Mailing Address - Zip Code:01475-1013
Mailing Address - Country:US
Mailing Address - Phone:978-342-2709
Mailing Address - Fax:
Practice Address - Street 1:63 FAIRMOUNT ST
Practice Address - Street 2:
Practice Address - City:FITCHBURG
Practice Address - State:MA
Practice Address - Zip Code:01420-7613
Practice Address - Country:US
Practice Address - Phone:508-733-0981
Practice Address - Fax:978-345-7166
Is Sole Proprietor?:No
Enumeration Date:2007-04-10
Last Update Date:2020-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)