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General NPI Number Information
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NPI Number | 1891650081
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Entity Type | Individual
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Provider Name | STEPHANIE BRADY
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Gender | Female
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Dates
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Enumeration Date | 12/19/2025
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Last Update Date | 12/19/2025
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Provider Practice Location Address
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Address Line | 630 PETER JEFFERSON PKWY STE 130
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City | CHARLOTTESVILLE
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State | VA
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Zip | 22911-4624
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Country | US
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Telephone | 434-448-3921
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Fax |
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Provider Business Mailing Address
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Address Line | 87 RIVERSIDE DR
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City | PALMYRA
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State | VA
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Zip | 22963-2019
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Country | US
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Telephone | 434-448-3921
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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 | 0903003042
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | BP00947351
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License Number State | WV
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