Provider Demographics
NPI:1326484239
Name:LYDAY, BRANDIE (LMFT CGACII CADCIII)
Entity Type:Individual
Prefix:
First Name:BRANDIE
Middle Name:
Last Name:LYDAY
Suffix:
Gender:F
Credentials:LMFT CGACII CADCIII
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16143 SW AUTUMN DR
Mailing Address - Street 2:
Mailing Address - City:BEAVERTON
Mailing Address - State:OR
Mailing Address - Zip Code:97007-4045
Mailing Address - Country:US
Mailing Address - Phone:971-203-2326
Mailing Address - Fax:971-203-2572
Practice Address - Street 1:4145 SW WATSON AVE STE 350
Practice Address - Street 2:
Practice Address - City:BEAVERTON
Practice Address - State:OR
Practice Address - Zip Code:97005-2191
Practice Address - Country:US
Practice Address - Phone:971-203-2326
Practice Address - Fax:971-203-2572
Is Sole Proprietor?:No
Enumeration Date:2013-05-17
Last Update Date:2023-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR19-03-28101YA0400X
ORT1503106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)