Provider Demographics
NPI:1164757993
Name:DUANE-BRADY, JAMI LYN (MED, EDS, LPC)
Entity Type:Individual
Prefix:MRS
First Name:JAMI
Middle Name:LYN
Last Name:DUANE-BRADY
Suffix:
Gender:F
Credentials:MED, EDS, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:307 4TH AVE
Mailing Address - Street 2:SUITE 310
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15222-2108
Mailing Address - Country:US
Mailing Address - Phone:412-471-8722
Mailing Address - Fax:412-471-4861
Practice Address - Street 1:307 4TH AVE
Practice Address - Street 2:SUITE 310
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15222-2108
Practice Address - Country:US
Practice Address - Phone:412-471-8722
Practice Address - Fax:412-471-4861
Is Sole Proprietor?:No
Enumeration Date:2009-10-13
Last Update Date:2012-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC005285101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA497537Medicaid