MEDICARE: JEANNE C BRADY PSYD, MA, LPC

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	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1326515669
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JEANNE C BRADY PSYD, MA, LPC

Provider Business Mailing Address
First Line	:	3061-C AURORA AVE
Second Line	:
City	:	JBER
State	:	AK
Zip	:	99506
Country	:	US
Telephone Number	:	907-444-8683
Fax Number	:

Provider Business Practice Location Address
First Line	:	2400 SPENARD RD STE 200
Second Line	:
City	:	ANCHORAGE
State	:	AK
Zip	:	99503-1644
Country	:	US
Telephone Number	:	855-573-4980
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/25/2018
Last Update Date	:	01/18/2025

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