Provider Demographics
NPI:1952679912
Name:TREADWAY, BRANDI J (LMFT, MPHIL)
Entity Type:Individual
Prefix:DR
First Name:BRANDI
Middle Name:J
Last Name:TREADWAY
Suffix:
Gender:F
Credentials:LMFT, MPHIL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:629 S WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:RIPLEY
Mailing Address - State:TN
Mailing Address - Zip Code:38063-2044
Mailing Address - Country:US
Mailing Address - Phone:731-324-3115
Mailing Address - Fax:
Practice Address - Street 1:629 S WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:RIPLEY
Practice Address - State:TN
Practice Address - Zip Code:38063-2044
Practice Address - Country:US
Practice Address - Phone:731-612-3385
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-06
Last Update Date:2024-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN1684106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty