Provider Demographics
NPI:1811139868
Name:BRADY, MEGAN MAUREEN (LCPC, ATR)
Entity type:Individual
Prefix:
First Name:MEGAN
Middle Name:MAUREEN
Last Name:BRADY
Suffix:
Gender:F
Credentials:LCPC, ATR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3954 W DAKIN ST
Mailing Address - Street 2:APT. 2A
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60618-3136
Mailing Address - Country:US
Mailing Address - Phone:630-738-9258
Mailing Address - Fax:
Practice Address - Street 1:3954 W DAKIN ST
Practice Address - Street 2:APT. 2A
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60618-3136
Practice Address - Country:US
Practice Address - Phone:630-738-9258
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-04-06
Last Update Date:2009-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180.007140101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional