Provider Demographics
NPI:1356069934
Name:BRADLEY, JULIE (LADAC II, NCAC II)
Entity type:Individual
Prefix:MRS
First Name:JULIE
Middle Name:
Last Name:BRADLEY
Suffix:
Gender:F
Credentials:LADAC II, NCAC II
Other - Prefix:MS
Other - First Name:JULIE
Other - Middle Name:
Other - Last Name:VERMILLION
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LADAC II, NCAC II
Mailing Address - Street 1:745 S CHURCH ST STE 505
Mailing Address - Street 2:
Mailing Address - City:MURFREESBORO
Mailing Address - State:TN
Mailing Address - Zip Code:37130-4980
Mailing Address - Country:US
Mailing Address - Phone:615-510-7500
Mailing Address - Fax:
Practice Address - Street 1:814 S CHURCH ST STE 222
Practice Address - Street 2:
Practice Address - City:MURFREESBORO
Practice Address - State:TN
Practice Address - Zip Code:37130-4991
Practice Address - Country:US
Practice Address - Phone:615-510-7500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-18
Last Update Date:2023-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN1478101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)