Provider Demographics
NPI:1588694582
Name:BREADY, BARBARA A (LICSW)
Entity type:Individual
Prefix:
First Name:BARBARA
Middle Name:A
Last Name:BREADY
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:40 WRIGHT ST
Mailing Address - Street 2:GRISWOLD CENTER
Mailing Address - City:PALMER
Mailing Address - State:MA
Mailing Address - Zip Code:01069-1138
Mailing Address - Country:US
Mailing Address - Phone:413-283-7651
Mailing Address - Fax:
Practice Address - Street 1:40 WRIGHT ST
Practice Address - Street 2:GRISWOLD CENTER
Practice Address - City:PALMER
Practice Address - State:MA
Practice Address - Zip Code:01069-1138
Practice Address - Country:US
Practice Address - Phone:413-283-7651
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-04
Last Update Date:2013-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT00056391041C0700X
MA1134651041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical