Doctor Name: | LUCY BRADY |
NPI Number: | 1467765404 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LCSW-R |
License Number: | R040438 |
Business Practice Address: | 2253 Story Ave Niskayuna, NY - 123095315 |
Business Phone Number: | 5183701243 |
Business Fax Number: | 5183704610 |
Mailing Address: | 20 Gould Dr, SCOTIA |
State: | NY |
Postal Code: | 123023238 |
Phone Number: | 5183464722 |
Fax Number: | 5183464722 |
NPI Enumeration Date: | 07/20/2010 |
NPI Last Update Date: | 07/20/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041S0200X |
License Number: | R040438 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NY |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | School |
Taxonomy Definition: |