Active NPI
Cheryl Robertson Bradley, LBS
- Behavior Analyst
- Walnutport, PA
National Provider Identifier
1174965644
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- 80-0941672
- Practice address
- 1299 Riverview Dr
Walnutport, PA 18088-9116 - Phone
- (201) 921-4481
- NPI assigned
- Jul 24, 2013
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | 80-0941672 | PA | Primary |
Addresses
Primary practice location
1299 Riverview Dr
Walnutport, PA 18088-9116
Mailing address
221 Skyline Dr
Suite 208 272
East Stroudsburg, PA 18301-1352
Phone (201) 921-4481
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 80-0941672 | PA | MD | Behavioral Analyst |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1374624000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1374624000000",
"number": "1174965644",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "221 SKYLINE DR",
"address_2": "SUITE 208 272",
"city": "EAST STROUDSBURG",
"state": "PA",
"postal_code": "183011352",
"telephone_number": "201-921-4481"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1299 RIVERVIEW DR",
"city": "WALNUTPORT",
"state": "PA",
"postal_code": "180889116",
"telephone_number": "201-921-4481"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRADLEY",
"first_name": "CHERYL",
"middle_name": "ROBERTSON",
"credential": "LBS",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2013-07-24",
"last_updated": "2013-07-24",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "PA",
"license": "80-0941672",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Walnutport, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.