Provider Demographics
NPI:1073108544
Name:BRADY, ELIZABETH (LCSW)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:
Last Name:BRADY
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 HIGHLAND BLVD
Mailing Address - Street 2:UNIT 209
Mailing Address - City:ARCHBALD
Mailing Address - State:PA
Mailing Address - Zip Code:18403-1516
Mailing Address - Country:US
Mailing Address - Phone:570-780-6333
Mailing Address - Fax:
Practice Address - Street 1:1 HIGHLAND BLVD
Practice Address - Street 2:UNIT 209
Practice Address - City:ARCHBALD
Practice Address - State:PA
Practice Address - Zip Code:18403-1516
Practice Address - Country:US
Practice Address - Phone:570-780-6333
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-05
Last Update Date:2023-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASW137933104100000X
PACW0238101041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker