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General NPI Number Information
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NPI Number | 1467133967
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Entity Type | Organization
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Legal Business Name | BRADLEY BEHAVIORAL HEALTH, PLLC
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Dates
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Enumeration Date | 07/27/2023
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Last Update Date | 07/27/2023
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Provider Practice Location Address
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Address Line | 3805 TOYON DR
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City | RALEIGH
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State | NC
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Zip | 27616-8605
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Country | US
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Telephone | 984-247-9774
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Fax | 984-223-7779
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Provider Business Mailing Address
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Address Line | 3805 TOYON DR
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City | RALEIGH
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State | NC
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Zip | 27616-8605
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | SHARON BRADLEY
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Credential | LCSW
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Telephone | 984-247-9774
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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