Provider Demographics
NPI:1689032146
Name:CUCURO, BRADLEY DAVID (LMSW)
Entity Type:Individual
Prefix:
First Name:BRADLEY
Middle Name:DAVID
Last Name:CUCURO
Suffix:
Gender:M
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22943 CLAIRWOOD ST
Mailing Address - Street 2:
Mailing Address - City:SAINT CLAIR SHORES
Mailing Address - State:MI
Mailing Address - Zip Code:48080-3412
Mailing Address - Country:US
Mailing Address - Phone:586-899-5943
Mailing Address - Fax:
Practice Address - Street 1:22943 CLAIRWOOD ST
Practice Address - Street 2:
Practice Address - City:SAINT CLAIR SHORES
Practice Address - State:MI
Practice Address - Zip Code:48080-3412
Practice Address - Country:US
Practice Address - Phone:586-899-5943
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-01-29
Last Update Date:2024-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other