Individual
BRADLEY D BURGESS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.A..
Contact information
Practice address
737 S MAIN ST, SOCIETY HILL, SC 29593-8972
(843) 378-4501
(843) 378-4209
Mailing address
PO BOX 1090, HARTSVILLE, SC 29551-1090
(843) 857-0111
(843) 857-0206
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
6071
SC
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
6071
SC
101YP2500X
Professional Counselor
Primary
6071
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PC1532
—
SC
Enumeration date
11/04/2010
Last updated
09/13/2017
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