Provider Demographics
NPI:1225162845
Name:BRADY, JOSEPH P (LCSW)
Entity Type:Individual
Prefix:MR
First Name:JOSEPH
Middle Name:P
Last Name:BRADY
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:661 RIVERSIDE DR
Mailing Address - Street 2:
Mailing Address - City:FAIRFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06824-6932
Mailing Address - Country:US
Mailing Address - Phone:203-814-6968
Mailing Address - Fax:
Practice Address - Street 1:1250 SUMMER ST
Practice Address - Street 2:SUITE 202
Practice Address - City:STAMFORD
Practice Address - State:CT
Practice Address - Zip Code:06905-5358
Practice Address - Country:US
Practice Address - Phone:203-454-6972
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-15
Last Update Date:2007-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker