Alicia Renae Brady, CCJP

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

SA0390128 Issued in MI

Practice address

537 Chicago Ave
Kalamazoo, MI 49048-2021

Phone

(269) 903-0539

NPI assigned

Sep 21, 2020

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 names 1

• Alicia Renae Jordan 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": "1600646400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600646400000",
    "number": "1457967911",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "537 CHICAGO AVE",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490482021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "537 CHICAGO AVE",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490482021",
            "telephone_number": "269-903-0539"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRADY",
        "first_name": "ALICIA",
        "middle_name": "RENAE",
        "credential": "CCJP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-09-21",
        "last_updated": "2020-09-21",
        "certification_date": "2020-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "MI",
            "license": "SA0390128",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ALICIA",
            "last_name": "JORDAN",
            "middle_name": "RENAE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Joshua R Bradish, MD
• Amber Dawn Bradley, LPC
• Kayona Bradley
• Ryan W Bradstreet, MD
• Tracy Bradstreet, NP
• Brandi Bragg
• Cody Brainard
• John Brainard, MD
• Braintrust Behavioral Health, LLC
• Brainwise Psychotherapy PLLC

• Addiction (Substance Use Disorder) Counselor in Kalamazoo, MI
• Providers in Kalamazoo, MI by specialty
• Addiction (Substance Use Disorder) Counselor in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2020; 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.