Stacy Bradley

Individual provider Active NPI Clinical Social Worker · Holly Springs, NC

NPI 1679723852 · NPPES record last updated Dec 30, 2025

Key facts

NPI
1679723852
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Social Worker 1041C0700X
License
P022353 (NC)
Practice address
380 Raleigh St
Holly Springs, NC 27540-9047
Phone
(919) 521-5372
NPI assigned
Sep 24, 2008
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
P022353NCMDClinical Social Worker

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker
Group: 193200000X MULTI-SPECIALTY GROUP
1041C0700X P022353 NC Yes

Addresses

Primary practice location

380 Raleigh St
Holly Springs, NC 27540-9047

Mailing address

380 Raleigh St
Holly Springs, NC 27540-9047
Phone (919) 521-5372

Other providers in Holly Springs, NC

All providers in Holly Springs, NC · Clinical Social Worker in North Carolina

Sources for this page

Verify at the official NPI Registry.