Provider Demographics
NPI:1245998863
Name:BRADY, FAYE (MSW)
Entity type:Individual
Prefix:
First Name:FAYE
Middle Name:
Last Name:BRADY
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:171 RIVER DR
Mailing Address - Street 2:
Mailing Address - City:HADLEY
Mailing Address - State:MA
Mailing Address - Zip Code:01035-9781
Mailing Address - Country:US
Mailing Address - Phone:973-951-0699
Mailing Address - Fax:
Practice Address - Street 1:171 RIVER DR
Practice Address - Street 2:
Practice Address - City:HADLEY
Practice Address - State:MA
Practice Address - Zip Code:01035-9781
Practice Address - Country:US
Practice Address - Phone:973-951-0699
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-12-01
Last Update Date:2021-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC053773001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical