Provider Demographics
NPI:1972978062
Name:HOLDEN, BRADLEN (MHS)
Entity type:Individual
Prefix:
First Name:BRADLEN
Middle Name:
Last Name:HOLDEN
Suffix:
Gender:M
Credentials:MHS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:108 ROYAL ST
Mailing Address - Street 2:
Mailing Address - City:NATCHITOCHES
Mailing Address - State:LA
Mailing Address - Zip Code:71457-5020
Mailing Address - Country:US
Mailing Address - Phone:318-554-8583
Mailing Address - Fax:
Practice Address - Street 1:108 ROYAL ST
Practice Address - Street 2:
Practice Address - City:NATCHITOCHES
Practice Address - State:LA
Practice Address - Zip Code:71457-5020
Practice Address - Country:US
Practice Address - Phone:318-554-8523
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-12-01
Last Update Date:2018-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral