Provider Demographics
NPI:1669350252
Name:FARLEY, BRADLEY (LSW)
Entity type:Individual
Prefix:MR
First Name:BRADLEY
Middle Name:
Last Name:FARLEY
Suffix:
Gender:M
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:65 AIRPORT PKWY STE 104
Mailing Address - Street 2:
Mailing Address - City:GREENWOOD
Mailing Address - State:IN
Mailing Address - Zip Code:46143-1439
Mailing Address - Country:US
Mailing Address - Phone:317-883-5308
Mailing Address - Fax:317-888-2138
Practice Address - Street 1:65 AIRPORT PKWY STE 104
Practice Address - Street 2:
Practice Address - City:GREENWOOD
Practice Address - State:IN
Practice Address - Zip Code:46143-1439
Practice Address - Country:US
Practice Address - Phone:317-883-5308
Practice Address - Fax:317-888-2138
Is Sole Proprietor?:No
Enumeration Date:2025-08-22
Last Update Date:2025-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN33009368A1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical