GLENETTA LASCHELLE BRADLEY, LCSW — NPI 1972831188 (Licensed & Credentialed Behavior Analyst in PERRY, OK)

CMS-1500 Box 24J / 33a • NPI

1972831188

Type 1 Individual Rendering/Ordering

HIPAA NUCC Taxonomy • CMS Code

103K00000X

Licensed & Credentialed Behavior Analyst

Box 32 Service Location & ZIP+4

502 N 14TH ST, PERRY, OK, 73077-5022

✓ 9-Digit EDI 837 ZIP+4 (73077-5022)

Practice Phone & Referral Fax

(918) 308-5512

Fax: (580) 215-5767

✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR: NPI 1972831188 (GLENETTA LASCHELLE BRADLEY, LCSW) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).

CMS Medicare Order & Referring PECOS Eligibility

This practitioner does not currently appear in the CMS individual Order & Referring PECOS file (may practice in pediatrics, commercial-only networks, or hospital-employed settings).

Official CMS NPPES Credential & Practice Profile

10-Digit NPI Number	`1972831188` (NPI-1 Individual Practitioner)
Provider / Legal Name	GLENETTA LASCHELLE BRADLEY, LCSW
Plain-English Specialty	Licensed & Credentialed Behavior Analyst NUCC Code: `103K00000X` (Behavior Analyst)
Certifying / Licensing Body	State Medical / Healthcare Licensing Board & National Specialty Board
Practice Location Address	502 N 14TH ST, PERRY, OK, 73077-5022
Practice Telephone / Fax	Tel: (918) 308-5512 \| Fax: (580) 215-5767
Administrative Mailing Address	502 N 14TH ST, PERRY, OK, 73077-5022
Enumeration & Last Sync	Enumerated: 2009-11-28 \| CMS Record Updated: 2026-10-07

Clinic Location, Accessibility & Directions

📍 Practice Location & Patient Access

502 N 14TH ST, PERRY, OK, 73077-5022

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Plain-English Taxonomy & CMS Crosswalk (103K00000X)

What Does Taxonomy Code 103K00000X Mean?

In the HIPAA National Uniform Claim Committee (NUCC) classification, code 103K00000X translates to:
"Licensed & Credentialed Behavior Analyst"

CMS-1500 Medicare Specialty Crosswalk: Standard HIPAA X12N 837P / CMS-1500
Certifying / Accrediting Authority: State Medical / Healthcare Licensing Board & National Specialty Board
Clinical Scope: Consult a verified Behavior Analyst for specialized diagnostic evaluation, treatment planning, and continuity of care.

Specialty Clinical Procedures & Therapeutic Classes

Standard Scope of Care (GLENETTA LASCHELLE BRADLEY, LCSW)

Typical CPT / Diagnostic Procedures:

Comprehensive Outpatient & Inpatient Clinical Evaluation (CPT 99202–99215)
Diagnostic Workup, Laboratory Ordering & Evidence-Based Care Coordination
Preventive Screening, Patient Counseling & Multidisciplinary Referral

Common Therapeutic Classes:

Evidence-Based Specialty Pharmacotherapy & Preventive Regimens (CMS Part D Standard)

All Registered NUCC Taxonomies & State Licenses

Taxonomy Code & Plain-English Description	State License & Primary Status
`103K00000X` — Behavior Analyst Plain English: Licensed & Credentialed Behavior Analyst	State: N/A \| License: `Verified` \| Primary: Secondary
`103K00000X` — Behavior Analyst Plain English: Licensed & Credentialed Behavior Analyst	State: GA \| License: `CSW009408` \| Primary: Yes (Primary)
`104100000X` — Social Worker Plain English: Licensed & Credentialed Social Worker	State: OK \| License: `7104` \| Primary: Secondary

Medical Billing, RCM & Hospital Credentialing Teams:

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GLENETTA LASCHELLE BRADLEY, LCSW (NPI #1972831188)