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NPI Code Detail

MEDICARE: STEPHANIE BRADY

MEDICARE: STEPHANIE BRADY
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
11041C0700XClinical Social Worker0903003042VA
21041C0700XClinical Social WorkerBP00947351WV

General Provider Information

NPI Number : 1891650081
Entity Type Code : Individual
Provider Name (Legal Business Name) : STEPHANIE BRADY
Provider Business Mailing Address
First Line : 87 RIVERSIDE DR
Second Line :
City : PALMYRA
State : VA
Zip : 22963-2019
Country : US
Telephone Number : 434-448-3921
Fax Number :
Provider Business Practice Location Address
First Line : 630 PETER JEFFERSON PKWY STE 130
Second Line :
City : CHARLOTTESVILLE
State : VA
Zip : 22911-4624
Country : US
Telephone Number : 434-448-3921
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/19/2025
Last Update Date : 12/19/2025

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Directions to “ STEPHANIE BRADY ” Practice Location

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