Individual
MR. BRADLEY BLACKBURN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCMHC, NCC
Contact information
Practice address
23 UNION ST N STE A, CONCORD, NC 28025-4726
(704) 918-5584
(833) 552-2077
Mailing address
PO BOX 1792, CONCORD, NC 28026-1792
(704) 918-5584
(833) 552-2077
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
16749
NC
101YP2500X
Professional Counselor
16749
NC
Other
Enumeration date
08/25/2021
Last updated
06/17/2025
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