| Doctor Name: | MS. MARY ANN MCELVEEN BRADSHAW |
| NPI Number: | 1104984756 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MSW, LCSW |
| License Number: | C002682 |
| Business Practice Address: | 1662 E Booker Dairy Rd Carolina Counseling & Consultation Services, Pa Smithfield, NC - 275779405 |
| Business Phone Number: | 9199380046 |
| Business Fax Number: | 9199380056 |
| Mailing Address: | 209 W Davis St Apt K, SMITHFIELD |
| State: | NC |
| Postal Code: | 275773872 |
| Phone Number: | 9199347115 |
| Fax Number: | |
| NPI Enumeration Date: | 12/05/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041C0700X |
| License Number: | C002682 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NC |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Social Worker |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | A social worker who holds a master |