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Deactivated NPI 1366579864 Deactivated / Inactive NPI Male Practitioner

Dr. Ottie Leon Bradshaw , EdD

Psychologist - Counseling • Springfield, MO

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Dr. Ottie Bradshaw has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date February 28, 2007
NPI Deactivation Date October 23, 2018
Total Practice Duration ~11 Years of Practice (2007 – 2018)

Professional Overview & Biography Verified Profile Summary

Dr. Ottie Bradshaw, EdD was a registered Psychologist - Counseling practicing in Springfield, MO. Throughout an active medical career spanning 11 years, Dr. Bradshaw provided care at the practice location at 1736 E SUNSHINE ST until profile deactivation on 2018-10-23.

Practice Location & Contact Primary Location

Practice Address

1736 E Sunshine St
Suite 811

Springfield, MO 658041343

Telephone 4178824485
Fax 4178825517
Associated Practice Facility / Clinic
🏢 Karlovich & Associates, Inc. Facility NPI 1184613119

Specialty Benchmarks & Practice Insights

Comparative analytics for Psychologist - Counseling in Springfield, MO

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 47.0 Yrs
State Avg: 25.6 Yrs
Regional Practice Density
6 Specialists

Practicing in Springfield, MO (145 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Psychologist - Counseling Primary Specialty

NUCC Taxonomy Code: 103TC1900X

State License MO 000353

A psychologist who specializes in general practice and health service. It focuses on how people function both personally and in their relationships at all ages. Counseling psychology addresses the emotional, social, work, school and physical health concerns people may have at different stages in their lives, focusing on typical life stresses and more severe issues with which people may struggle as individuals and as a part of families, groups and organizations. Counseling psychologists help people with physical, emotional and mental health issues improve their sense of well-being, alleviate feelings of distress and resolve crises. They also provide assessment, diagnosis, and treatment of more severe psychological symptoms.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

12 Associated Practitioners
Jane Dosch

Counselor - Professional

NPI 1215064894
Annette Arms , LPC

Counselor - Mental Health

NPI 1245865500

Licensed Professional Counselor

Mitchell Mcfall , MS, LPC

Counselor - Mental Health

NPI 1255498267

Master of Science, Licensed Professional Counselor

Dr. Sara Hollis , PsyD

Psychologist - Clinical

NPI 1528049392

Doctor of Psychology (Psy.D.)

Dr. Paul Blisard , EdD, LPC

Counselor - Professional

NPI 1700913605

Doctor of Education (Ed.D.), Licensed Professional Counselor

Victoria Zettl , PLPC

Counselor - Professional

NPI 1740935493

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events
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NPI Profile Deactivated October 23, 2018

Record deactivated on October 23, 2018

NPI Profile Active July 08, 2007

NPI status registered as active in NPPES database

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Updated Practice Location July 08, 2007

Registered at 1736 E SUNSHINE ST, SUITE 811, SPRINGFIELD, MO 658041343 (Tel: 4178824485)

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Updated Business Mailing Address July 08, 2007

Registered at 9891 E FARM ROAD 160, ROGERSVILLE, MO 657427529 (Tel: 4177533475)

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Provider Name / Credentials Updated July 08, 2007

Recorded as OTTIE BRADSHAW, ED.D.

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Medical Taxonomy / Specialty Registered (Primary Specialty) July 08, 2007

Psychologist (License #000353 in MO)

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Initial NPI Registration & Enumeration February 28, 2007

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1366579864
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: February 28, 2007
Last Update: July 08, 2007
Deactivation Date: October 23, 2018

Mailing Address

9891 E Farm Road 160

Rogersville, MO 657427529

Phone: 4177533475

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

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