Brendar Brady, LAC

Primary specialty

CounselorTaxonomy code 101Y00000X

License

37AC00770000 Issued in NJ

Practice address

1 Lupton Ave
Woodbury, NJ 08096-5901

Phone

(856) 693-5775

NPI assigned

Apr 15, 2024

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Brendar Lieur Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1713139200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719446400000",
    "number": "1205680451",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 LUPTON AVE",
            "city": "WOODBURY",
            "state": "NJ",
            "postal_code": "080965901",
            "telephone_number": "856-693-5775"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 LUPTON AVE",
            "city": "WOODBURY",
            "state": "NJ",
            "postal_code": "080965901",
            "telephone_number": "856-693-5775"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRADY",
        "first_name": "BRENDAR",
        "credential": "LAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-04-15",
        "last_updated": "2024-06-27",
        "certification_date": "2024-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "NJ",
            "license": "37AC00770000",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0990264",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BRENDAR",
            "last_name": "LIEUR",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Victoria Boccella
• Anthony W Bonett, MD
• James M. Bonner, D.O.
• Brian W. Boockoff, PA-C
• Booth Radiology Associates PA
• Theresa B Brady, CRNP
• Jolene Bredrick, LMFT
• Gregory Breen, M.D.
• Stephanie Briggs
• Michael Bronstein, D.M.D.

• Counselor in Woodbury, NJ
• Providers in Woodbury, NJ by specialty
• Counselor in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2024; 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.