Individual
BRADY JIM BERGMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPC-T
Contact information
Practice address
7926 W 21ST ST N, WICHITA, KS 67205-1742
(316) 272-5502
(316) 462-5640
Mailing address
7926 W 21ST ST N, WICHITA, KS 67205-1742
(316) 272-5502
(316) 462-5640
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
04452
KS
Other
Enumeration date
07/25/2023
Last updated
08/24/2023
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