Provider Demographics
NPI:1982861548
Name:BRADY, NOREEN R (PHD, APRN-BC, LPCC)
Entity Type:Individual
Prefix:DR
First Name:NOREEN
Middle Name:R
Last Name:BRADY
Suffix:
Gender:F
Credentials:PHD, APRN-BC, LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6718 CRESTWOOD LN
Mailing Address - Street 2:
Mailing Address - City:OLMSTED FALLS
Mailing Address - State:OH
Mailing Address - Zip Code:44138-1145
Mailing Address - Country:US
Mailing Address - Phone:440-235-1867
Mailing Address - Fax:216-368-3542
Practice Address - Street 1:13422 KINSMAN RD
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44120-4410
Practice Address - Country:US
Practice Address - Phone:216-241-7223
Practice Address - Fax:216-241-7262
Is Sole Proprietor?:No
Enumeration Date:2008-05-21
Last Update Date:2008-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN.141034364SP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SP0809XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health, Adult