Provider Demographics
NPI:1831703008
Name:BRADY, CAITLIN (LCSW, CEDS, RYT)
Entity type:Individual
Prefix:
First Name:CAITLIN
Middle Name:
Last Name:BRADY
Suffix:
Gender:F
Credentials:LCSW, CEDS, RYT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:248 WARWICK RD
Mailing Address - Street 2:
Mailing Address - City:ELVERSON
Mailing Address - State:PA
Mailing Address - Zip Code:19520-8925
Mailing Address - Country:US
Mailing Address - Phone:732-539-5051
Mailing Address - Fax:
Practice Address - Street 1:127 E CHESTNUT ST
Practice Address - Street 2:
Practice Address - City:WEST CHESTER
Practice Address - State:PA
Practice Address - Zip Code:19380-2651
Practice Address - Country:US
Practice Address - Phone:732-539-5051
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-03
Last Update Date:2021-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASW135294104100000X
PACW0216441041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker