Provider Demographics
NPI:1437926714
Name:BRODY, REUBEN JASON (LCSWA)
Entity Type:Individual
Prefix:
First Name:REUBEN
Middle Name:JASON
Last Name:BRODY
Suffix:
Gender:M
Credentials:LCSWA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:63 MAGNOLIA AVE
Mailing Address - Street 2:
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28801-1728
Mailing Address - Country:US
Mailing Address - Phone:919-280-9091
Mailing Address - Fax:
Practice Address - Street 1:77 CENTRAL AVE STE D
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28801-4256
Practice Address - Country:US
Practice Address - Phone:828-333-9320
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-12-07
Last Update Date:2023-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP0187861041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical