Healthcare Provider Details

I. General information

NPI: 1457921041
Provider Name (Legal Business Name): MRS. BRANDY MAE MCCAREY-BAIN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/28/2021
Last Update Date: 02/06/2025
Certification Date: 02/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1510 VALLEY CENTER PKWY STE 200
BETHLEHEM PA
18017-2267
US

IV. Provider business mailing address

640 FREEDOM BUSINESS CTR DR STE 220
KING OF PRUSSIA PA
19406-1376
US

V. Phone/Fax

Practice location:
  • Phone: 570-396-6189
  • Fax:
Mailing address:
  • Phone: 570-802-3099
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License NumberBH007424
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: