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Individual
TERESA R BRADLEY
Active
Individual
TERESA R BRADLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW, LCAC
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
34006341A
IN
101YA0400X
Addiction (Substance Use Disorder) Counselor
87001383A
IN
1041C0700X
Clinical Social Worker
Primary
34006341A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300004581
—
IN
Enumeration date
11/30/2011
Last updated
08/05/2026
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