Individual
KYANA BRADLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC, LCPC
Contact information
Practice address
8101 SANDY SPRING RD STE 250, LAUREL, MD 20707-3527
(202) 344-7933
(240) 366-5750
Mailing address
909 4TH ST APT D, LAUREL, MD 20707-5121
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
LC8316
MD
101Y00000X
Counselor
PRC14889
DC
101YM0800X
Mental Health Counselor
Primary
LC8316
MD
101YM0800X
Mental Health Counselor
PRC14889
DC
101YP2500X
Professional Counselor
LC8316
MD
101YP2500X
Professional Counselor
PRC14889
DC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
907084200
—
MD
Enumeration date
05/07/2018
Last updated
06/11/2019
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