Provider Demographics
NPI:1457921041
Name:MCCAREY-BAIN, BRANDY MAE
Entity type:Individual
Prefix:MRS
First Name:BRANDY
Middle Name:MAE
Last Name:MCCAREY-BAIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:640 FREEDOM BUSINESS CTR DR STE 220
Mailing Address - Street 2:
Mailing Address - City:KING OF PRUSSIA
Mailing Address - State:PA
Mailing Address - Zip Code:19406-1376
Mailing Address - Country:US
Mailing Address - Phone:570-802-3099
Mailing Address - Fax:
Practice Address - Street 1:1510 VALLEY CENTER PKWY STE 200
Practice Address - Street 2:
Practice Address - City:BETHLEHEM
Practice Address - State:PA
Practice Address - Zip Code:18017-2267
Practice Address - Country:US
Practice Address - Phone:570-396-6189
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-28
Last Update Date:2025-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA106S00000X
PABH007424103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician