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Organization
KAREN BRADT
Active
Organization
KAREN BRADT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KAREN BRADT LCSW (OWNER)
(386) 310-3646
Entity
Organization
Contact information
Practice address
84 PINE TRL, ORMOND BEACH, FL 32174-6932
(386) 310-3646
Mailing address
84 PINE TRL, ORMOND BEACH, FL 32174-6932
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
019270200
—
FL
Enumeration date
04/23/2019
Last updated
04/23/2019
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