Healthcare Provider Details

I. General information

NPI: 1841300613
Provider Name (Legal Business Name): CYNTHIA M BRADY PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/30/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7006 NW 63RD SUITE 204
BETHANY OK
73008-1953
US

IV. Provider business mailing address

7006 NW 63RD SUITE 204
BETHANY OK
73008-1953
US

V. Phone/Fax

Practice location:
  • Phone: 405-720-6335
  • Fax:
Mailing address:
  • Phone: 405-720-6335
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number152
License Number StateOK
# 2
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number057
License Number StateOK

VIII. Authorized Official

Name: MS. CYNTHIA M BRADY
Title or Position: PRESIDENT
Credential: LMFT LPC
Phone: 405-720-6335