Individual provider Active NPI

Elizabeth Brady, LCSW

  • Clinical Social Worker
  • Archbald, PA
National Provider Identifier
1073108544
Registry record updated Dec 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
CW023810 Issued in PA
Practice address
1 Highland Blvd
Unit 209
Archbald, PA 18403-1516
Phone
(570) 780-6333
NPI assigned
Mar 5, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 28, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X SW137933 PA
Clinical Social Worker 1041C0700X CW023810 PA Primary

Addresses

Primary practice location

1 Highland Blvd
Unit 209
Archbald, PA 18403-1516

Mailing address

1 Highland Blvd
Unit 209
Archbald, PA 18403-1516
Phone (570) 780-6333

Medicare participation

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
SW137933PAMDSocial Worker
CW023810PAMDClinical Social Worker

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1614902400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703721600000",
    "number": "1073108544",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 HIGHLAND BLVD",
            "address_2": "UNIT 209",
            "city": "ARCHBALD",
            "state": "PA",
            "postal_code": "184031516",
            "telephone_number": "570-780-6333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 HIGHLAND BLVD",
            "address_2": "UNIT 209",
            "city": "ARCHBALD",
            "state": "PA",
            "postal_code": "184031516",
            "telephone_number": "570-780-6333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRADY",
        "first_name": "ELIZABETH",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-03-05",
        "last_updated": "2023-12-28",
        "certification_date": "2023-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "PA",
            "license": "SW137933",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "PA",
            "license": "CW023810",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Archbald, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.