Provider Demographics
NPI:1124061874
Name:MORROW-BRADLEY, CHERYL ANN (PHD)
Entity type:Individual
Prefix:DR
First Name:CHERYL
Middle Name:ANN
Last Name:MORROW-BRADLEY
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2444 COMMERCE RD
Mailing Address - Street 2:STE 125
Mailing Address - City:JACKSONVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28546-7561
Mailing Address - Country:US
Mailing Address - Phone:910-238-2166
Mailing Address - Fax:910-333-0639
Practice Address - Street 1:2444 COMMERCE RD
Practice Address - Street 2:STE 125
Practice Address - City:JACKSONVILLE
Practice Address - State:NC
Practice Address - Zip Code:28546-7561
Practice Address - Country:US
Practice Address - Phone:910-238-2166
Practice Address - Fax:910-333-0639
Is Sole Proprietor?:No
Enumeration Date:2006-06-13
Last Update Date:2023-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6301006244103T00000X
OH3658103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0879821Medicaid
OHF55525Medicare UPIN
OHCP11532Medicare ID - Type UnspecifiedMEDICARE NUMBER