Provider Demographics
NPI:1609587575
Name:BRUDNAK, BARRY LEE (MS, CAADC, LPC)
Entity Type:Individual
Prefix:
First Name:BARRY
Middle Name:LEE
Last Name:BRUDNAK
Suffix:
Gender:M
Credentials:MS, CAADC, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:312 MEADOW AVE
Mailing Address - Street 2:
Mailing Address - City:CHARLEROI
Mailing Address - State:PA
Mailing Address - Zip Code:15022-1214
Mailing Address - Country:US
Mailing Address - Phone:412-965-4007
Mailing Address - Fax:
Practice Address - Street 1:312 MEADOW AVE
Practice Address - Street 2:
Practice Address - City:CHARLEROI
Practice Address - State:PA
Practice Address - Zip Code:15022-1214
Practice Address - Country:US
Practice Address - Phone:412-965-4007
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-12-12
Last Update Date:2022-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC015130101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAPC015130OtherLPC