Individual
BRADLEY SCOTT THORNTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPC-MHSP
Contact information
Practice address
1330 NEAL ST STE D, COOKEVILLE, TN 38501-4307
(931) 528-6803
(931) 528-6826
Mailing address
2101 MAGNOLIA AVE S STE 518, BIRMINGHAM, AL 35205-2853
(205) 244-8134
(205) 251-7760
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
4690
TN
101YM0800X
Mental Health Counselor
Primary
4690
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4690
STATE OF TENNESSEE
TN
Enumeration date
12/10/2019
Last updated
12/10/2019
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