Provider Demographics
NPI:1881881209
Name:BRADLEY, CINDY YOLANDA (LCSW)
Entity type:Individual
Prefix:MS
First Name:CINDY
Middle Name:YOLANDA
Last Name:BRADLEY
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11111 N HARRELLS FERRY RD
Mailing Address - Street 2:APT #197
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70816-8389
Mailing Address - Country:US
Mailing Address - Phone:225-757-6929
Mailing Address - Fax:
Practice Address - Street 1:11111 N HARRELLS FERRY RD
Practice Address - Street 2:APT #197
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70816-8389
Practice Address - Country:US
Practice Address - Phone:225-757-6929
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-30
Last Update Date:2007-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA61721041C0700X
AL2092C1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical