Cynthia Marie Brady, CDPT | NPI 1003383597

Key facts

NPI: 1003383597
Entity type: Individual (NPI type 1)
Primary specialty: Addiction (Substance Use Disorder) Counselor 101YA0400X
License: CO60776388 (WA)
Practice address: 19351 8TH Ave NE Ste 141
Poulsbo, WA 98370-7087
Phone: (360) 598-3929
Fax: (360) 598-4114
NPI assigned: Nov 1, 2018
Sex: Female
Sole proprietor: No

Medicare participation

Medicare fee-for-service enrollment: Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD): No

State licenses

License	State	Type	Specialty
CO60776388	WA	MD	Addiction (Substance Use Disorder) Counselor

Interoperability endpoints

FHIR API: https://api.platform.athenahealth.com/19590/brand/1/csg/1/fhir/r4

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Addiction (Substance Use Disorder) Counselor	101YA0400X	CO60776388	WA	Yes

Addresses

Primary practice location

19351 8TH Ave NE Ste 141
Poulsbo, WA 98370-7087

Mailing address

19351 8TH Ave NE Ste 141
Poulsbo, WA 98370-7087
Phone (360) 598-3929

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Nov 1, 2018.

{
    "created_epoch": "1541030400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1541030400000",
    "number": "1003383597",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19351 8TH AVE NE STE 141",
            "city": "POULSBO",
            "state": "WA",
            "postal_code": "983707087",
            "telephone_number": "360-598-3929",
            "fax_number": "360-598-4114"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19351 8TH AVE NE STE 141",
            "city": "POULSBO",
            "state": "WA",
            "postal_code": "983707087",
            "telephone_number": "360-598-3929",
            "fax_number": "360-598-4114"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRADY",
        "first_name": "CYNTHIA",
        "middle_name": "MARIE",
        "name_prefix": "Ms.",
        "credential": "CDPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-11-01",
        "last_updated": "2018-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WA",
            "license": "CO60776388",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Poulsbo, WA

All providers in Poulsbo, WA · Addiction (Substance Use Disorder) Counselor in Washington

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 1, 2018. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.