Provider Demographics
NPI:1407033921
Name:BRADY, JESSICA PAIGE (LPC-MHSP)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:PAIGE
Last Name:BRADY
Suffix:
Gender:F
Credentials:LPC-MHSP
Other - Prefix:
Other - First Name:JESSICA
Other - Middle Name:PAIGE
Other - Last Name:HALL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:10025 INVESTMENT DR STE 100
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37932-2665
Mailing Address - Country:US
Mailing Address - Phone:865-606-6110
Mailing Address - Fax:865-312-6442
Practice Address - Street 1:10025 INVESTMENT DR STE 100
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37932-2665
Practice Address - Country:US
Practice Address - Phone:865-606-6110
Practice Address - Fax:865-312-6442
Is Sole Proprietor?:No
Enumeration Date:2008-01-28
Last Update Date:2022-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN5549101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional