MEDICARE: DARCIE 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
1	1041C0700X	Clinical Social Worker	2022038456	MO

General Provider Information

NPI Number	:	1912665712
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DARCIE BRADY

Provider Business Mailing Address
First Line	:	1036 GARDENBRIDGE PL
Second Line	:
City	:	SAINT CHARLES
State	:	MO
Zip	:	63303-4820
Country	:	US
Telephone Number	:	314-265-3857
Fax Number	:

Provider Business Practice Location Address
First Line	:	2451 EXECUTIVE DR STE 205
Second Line	:
City	:	SAINT CHARLES
State	:	MO
Zip	:	63303-5606
Country	:	US
Telephone Number	:	314-858-6498
Fax Number	:

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

Provider Enumeration Date	:	11/30/2021
Last Update Date	:	11/18/2022

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Directions to “ DARCIE BRADY ” Practice Location

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