| Doctor Name: | MR. JEFFERY LAMONT BRADY |
| NPI Number: | 1568796787 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | MHS |
| License Number: | |
| Business Practice Address: | 9 Harding Hwy Pittsgrove, NJ - 083184401 |
| Business Phone Number: | 8563584111 |
| Business Fax Number: | |
| Mailing Address: | 4730 Charles Ter, PHILADELPHIA |
| State: | PA |
| Postal Code: | 191245704 |
| Phone Number: | 6104537204 |
| Fax Number: | |
| NPI Enumeration Date: | 09/21/2009 |
| NPI Last Update Date: | 09/21/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YA0400X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Addiction (Substance Use Disorder) |
| Taxonomy Definition: | |