Provider Demographics
NPI:1952764110
Name:BRACKENS, CHERRY L (LMSW)
Entity Type:Individual
Prefix:MRS
First Name:CHERRY
Middle Name:L
Last Name:BRACKENS
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:MISS
Other - First Name:CHERRY
Other - Middle Name:L
Other - Last Name:DANCER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1112 E COPELAND RD
Mailing Address - Street 2:SUITE 310
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76011-4910
Mailing Address - Country:US
Mailing Address - Phone:817-522-5052
Mailing Address - Fax:
Practice Address - Street 1:1112 E COPELAND RD
Practice Address - Street 2:SUITE 310
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76011-4910
Practice Address - Country:US
Practice Address - Phone:817-522-5052
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-04-04
Last Update Date:2016-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health