Provider Demographics
NPI:1689411779
Name:BRADLEY, ANA CUBELLS (LCSW-S)
Entity type:Individual
Prefix:MRS
First Name:ANA
Middle Name:CUBELLS
Last Name:BRADLEY
Suffix:
Gender:F
Credentials:LCSW-S
Other - Prefix:MRS
Other - First Name:ANNA
Other - Middle Name:CUBELLS
Other - Last Name:BRADLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1714 LEXINGTON ST
Mailing Address - Street 2:
Mailing Address - City:TAYLOR
Mailing Address - State:TX
Mailing Address - Zip Code:76574-1561
Mailing Address - Country:US
Mailing Address - Phone:808-462-0239
Mailing Address - Fax:
Practice Address - Street 1:1714 LEXINGTON ST
Practice Address - Street 2:
Practice Address - City:TAYLOR
Practice Address - State:TX
Practice Address - Zip Code:76574-1561
Practice Address - Country:US
Practice Address - Phone:808-462-0239
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-15
Last Update Date:2024-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX625851041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical