Provider Demographics
NPI:1669919312
Name:BRADY MENTAL HEALTH & WELLNESS
Entity type:Organization
Organization Name:BRADY MENTAL HEALTH & WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:BRADY
Authorized Official - Suffix:
Authorized Official - Credentials:LCPC
Authorized Official - Phone:410-303-3438
Mailing Address - Street 1:1223 TILLERMAN PL
Mailing Address - Street 2:
Mailing Address - City:CHESTNUT HILL COVE
Mailing Address - State:MD
Mailing Address - Zip Code:21226-2225
Mailing Address - Country:US
Mailing Address - Phone:410-303-3438
Mailing Address - Fax:410-705-0535
Practice Address - Street 1:877 BALTIMORE ANNAPOLIS BLVD
Practice Address - Street 2:SUITE 202
Practice Address - City:SEVERNA PARK
Practice Address - State:MD
Practice Address - Zip Code:21146-4700
Practice Address - Country:US
Practice Address - Phone:410-303-3438
Practice Address - Fax:410-705-0535
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-19
Last Update Date:2017-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLC5028101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty