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General NPI Number Information
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NPI Number | 1891504874
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Entity Type | Organization
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Legal Business Name | JENNIFER BRADY LICENSED CLINICAL SOCIAL WORKER PC
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Dates
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Enumeration Date | 01/03/2025
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Last Update Date | 03/03/2025
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Provider Practice Location Address
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Address Line | 2660 TOWNSGATE RD STE 520
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City | WESTLAKE VILLAGE
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State | CA
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Zip | 91361-5712
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Country | US
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Telephone | 310-907-6580
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Fax |
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Provider Business Mailing Address
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Address Line | 490 NOVARA WAY
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City | OAK PARK
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State | CA
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Zip | 91377-5556
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Country | US
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Telephone | 310-907-6580
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | JENNIFER BRADY
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Credential | LCSW
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Telephone | 310-907-6580
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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 |
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License Number State |
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