Provider Demographics
NPI:1396941761
Name:BRADY, ELIZABETH MAY (MA, LPC)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:MAY
Last Name:BRADY
Suffix:
Gender:F
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:225 ADDISON ROAD
Mailing Address - Street 2:SUITE 203
Mailing Address - City:GLASTONBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06033
Mailing Address - Country:US
Mailing Address - Phone:860-372-2140
Mailing Address - Fax:
Practice Address - Street 1:225 ADDISON ROAD
Practice Address - Street 2:SUITE 203
Practice Address - City:GLASTONBURY
Practice Address - State:CT
Practice Address - Zip Code:06033-1606
Practice Address - Country:US
Practice Address - Phone:860-432-7588
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-22
Last Update Date:2024-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YP2500X
CT001786101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional