Provider Demographics
NPI:1932858875
Name:BRADY, LINDSAY DANIELLE (MA)
Entity type:Individual
Prefix:
First Name:LINDSAY
Middle Name:DANIELLE
Last Name:BRADY
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:53 ASHMOOR LN
Mailing Address - Street 2:
Mailing Address - City:SUMMERSVILLE
Mailing Address - State:WV
Mailing Address - Zip Code:26651-4576
Mailing Address - Country:US
Mailing Address - Phone:304-651-2909
Mailing Address - Fax:
Practice Address - Street 1:603 BROAD ST
Practice Address - Street 2:
Practice Address - City:SUMMERSVILLE
Practice Address - State:WV
Practice Address - Zip Code:26651-1307
Practice Address - Country:US
Practice Address - Phone:304-872-9645
Practice Address - Fax:304-872-9643
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-19
Last Update Date:2022-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Single Specialty
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health