MEDICARE: BRADY'S YOUTH AND DEVELOPMENT CENTER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251S00000X	Community/Behavioral Health Agency

General Provider Information

NPI Number	:	1053702100
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BRADY'S YOUTH AND DEVELOPMENT CENTER

Provider Business Mailing Address
First Line	:	169 PARK FAIRFAX DR
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28208-4442
Country	:	US
Telephone Number	:	704-497-8902
Fax Number	:

Provider Business Practice Location Address
First Line	:	169 PARK FAIRFAX DR
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28208-4442
Country	:	US
Telephone Number	:	704-497-8902
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	JOHNNY BRADY
Credential	:
Telephone Number	:	704-497-8902

Provider Enumeration Date	:	02/11/2015
Last Update Date	:	02/12/2015

Similar Medicare Providers

1053267476 — ALEXIS MITCHELL
Practice Location Address:

2431 RADRICK LN
CHARLOTTE, NC
28262-4442

Practice Phone: 980-415-5638
Practice Fax:

1073963112 — DR. STEFANOS KOTSOKALIS O.D.
Practice Location Address:

15640 DON LOCHMAN LN STE C
CHARLOTTE, NC
28277-4442

Practice Phone: 704-943-5110
Practice Fax:

1639623853 — AMANDA RICKHER O.D.
Practice Location Address:

15640 DON LOCHMAN LN STE C
CHARLOTTE, NC
28277-4442

Practice Phone: 704-943-5110
Practice Fax:

1275123275 — REBECCA LACHAPELL BCBA
Practice Location Address:

4442 GOLDEN VIEW DR
CHARLOTTE, NC
28278-0205

Practice Phone: 980-279-2256
Practice Fax:

1487442364 — GRACE DYKE CPNP-PC
Practice Location Address:

5211 GLENBRIER DR
CHARLOTTE, NC
28212-4442

Practice Phone: 203-768-6708
Practice Fax:

1942150172 — BUILDING BRIDGES ABA LLC
Practice Location Address:

4442 GOLDEN VIEW DR
CHARLOTTE, NC
28278-0205

Practice Phone: 980-279-2256
Practice Fax:

Directions to “BRADY'S YOUTH AND DEVELOPMENT CENTER ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.