Provider Demographics
NPI:1164181400
Name:AHERN, BRAD
Entity type:Individual
Prefix:
First Name:BRAD
Middle Name:
Last Name:AHERN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:851 FRANKLIN LAKE RD STE 204
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN LAKES
Mailing Address - State:NJ
Mailing Address - Zip Code:07417-2267
Mailing Address - Country:US
Mailing Address - Phone:833-937-2724
Mailing Address - Fax:
Practice Address - Street 1:851 FRANKLIN LAKE RD STE 204
Practice Address - Street 2:
Practice Address - City:FRANKLIN LAKES
Practice Address - State:NJ
Practice Address - Zip Code:07417-2267
Practice Address - Country:US
Practice Address - Phone:833-937-2724
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-12-14
Last Update Date:2025-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ35SI00784700103T00000X
NJ37AC00595400101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist