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General NPI Number Information
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NPI Number | 1003321159
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Entity Type | Individual
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Provider Name | THOMAS W BRADY LCSW
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Gender | Male
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Dates
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Enumeration Date | 12/12/2017
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Last Update Date | 08/06/2025
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Provider Practice Location Address
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Address Line | 1601 SW ARCHER RD
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City | GAINESVILLE
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State | FL
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Zip | 32608-1135
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Country | US
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Telephone | 352-293-6612
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Fax |
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Provider Business Mailing Address
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Address Line | 5216 HOPE LN
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City | SPRING HILL
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State | FL
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Zip | 34606-1232
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Country | US
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Telephone | 352-293-6612
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | SW13644
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License Number State | FL
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