Provider Demographics
NPI:1841300613
Name:CYNTHIA M BRADY PC
Entity type:Organization
Organization Name:CYNTHIA M BRADY PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:CYNTHIA
Authorized Official - Middle Name:M
Authorized Official - Last Name:BRADY
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT LPC
Authorized Official - Phone:405-720-6335
Mailing Address - Street 1:7006 NW 63RD
Mailing Address - Street 2:SUITE 204
Mailing Address - City:BETHANY
Mailing Address - State:OK
Mailing Address - Zip Code:73008-1953
Mailing Address - Country:US
Mailing Address - Phone:405-720-6335
Mailing Address - Fax:
Practice Address - Street 1:7006 NW 63RD
Practice Address - Street 2:SUITE 204
Practice Address - City:BETHANY
Practice Address - State:OK
Practice Address - Zip Code:73008-1953
Practice Address - Country:US
Practice Address - Phone:405-720-6335
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-30
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK152101Y00000X
OK057106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty