Provider Demographics
NPI:1528496890
Name:BRADY, JEAN WALKER (LCSW)
Entity type:Individual
Prefix:MS
First Name:JEAN
Middle Name:WALKER
Last Name:BRADY
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:42 ARIZONA STATE DR
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:DE
Mailing Address - Zip Code:19713-1144
Mailing Address - Country:US
Mailing Address - Phone:302-528-5004
Mailing Address - Fax:
Practice Address - Street 1:100 BIDDLE AVE STE 123
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19702-3982
Practice Address - Country:US
Practice Address - Phone:302-669-9252
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-10-24
Last Update Date:2021-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEQ1-00012451041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical