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General NPI Number Information
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NPI Number | 1396941761
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Entity Type | Individual
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Provider Name | ELIZABETH MAY BRADY M.A., LPC
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Gender | Female
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Dates
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Enumeration Date | 06/22/2007
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Last Update Date | 09/06/2024
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Provider Practice Location Address
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Address Line | 225 ADDISON ROAD SUITE 203
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City | GLASTONBURY
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State | CT
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Zip | 06033-1606
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Country | US
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Telephone | 860-432-7588
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Fax |
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Provider Business Mailing Address
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Address Line | 225 ADDISON ROAD SUITE 203
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City | GLASTONBURY
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State | CT
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Zip | 06033
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Country | US
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Telephone | 860-372-2140
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 001786
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License Number State | CT
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