Individual provider Active NPI

Hallie Brady, LPC

  • Professional Counselor
  • New Haven, CT
National Provider Identifier
1770062739
Registry record updated Feb 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
005730 Issued in CT
Practice address
189 Orange St
New Haven, CT 06510-2014
Phone
(203) 937-2309
NPI assigned
Aug 10, 2018
Last updated
Feb 28, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 28, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 5730 CT
Mental Health Counselor 101YM0800X 73859 TX
Professional Counselor 101YP2500X 005730 CT Primary

Addresses

Primary practice location

189 Orange St
New Haven, CT 06510-2014

Mailing address

189 Orange St
New Haven, CT 06510-2014

Other practice location 1

5351 Samuell Blvd
Dallas, TX 75228-6720
Phone (214) 818-2642

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240614001723 CT Practitioner - Mental Health Counselor 0143763441 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5730CTMDMental Health Counselor
73859TXMDMental Health Counselor
005730CTMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Optum Behavioral Care of Connecticut, P.C. CurrentSince May 9, 2024 Accepting new patients
Optum Behavioral Care of Connecticut, P.C. CurrentSince May 9, 2024 Accepting new patients
Dallas Children's Advocacy Center Professional Past Accepting new patients
CT Clinical Services, Inc. PastSince Oct 30, 2022 Accepting new patients
Dallas Children's Advocacy Center Past Accepting new patients

Locations

169 Main St
Fl 3
Middletown, CT 06457
Phone (610) 618-6247

Interoperability endpoints

  • Direct secure messaging: hallie.brady.1@28623.direct.athenahealth.com

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1533859200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709078400000",
    "number": "1770062739",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "189 ORANGE ST",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065102014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "189 ORANGE ST",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065102014",
            "telephone_number": "203-937-2309"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5351 Samuell Blvd",
            "address_purpose": "LOCATION",
            "city": "Dallas",
            "state": "TX",
            "postal_code": "752286720",
            "country_code": "US",
            "telephone_number": "214-818-2642",
            "fax_number": "214-818-2645",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BRADY",
        "first_name": "HALLIE",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-10",
        "last_updated": "2024-02-28",
        "certification_date": "2024-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CT",
            "license": "5730",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "TX",
            "license": "73859",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "CT",
            "license": "005730",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Haven, CT

Sources for this page

Verify at the official NPI Registry.