Provider Demographics
NPI:1609027820
Name:BRADLEY, CHEROKEE TENNILLE (PLMSW)
Entity Type:Individual
Prefix:MS
First Name:CHEROKEE
Middle Name:TENNILLE
Last Name:BRADLEY
Suffix:
Gender:F
Credentials:PLMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 251970
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72225-1970
Mailing Address - Country:US
Mailing Address - Phone:501-666-8686
Mailing Address - Fax:501-660-6830
Practice Address - Street 1:5509 FOREST PLACE
Practice Address - Street 2:SUTIE 100
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72207
Practice Address - Country:US
Practice Address - Phone:501-666-4949
Practice Address - Fax:501-660-6840
Is Sole Proprietor?:No
Enumeration Date:2008-10-07
Last Update Date:2008-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker