Colin Hugh Brady, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

0701011782 Issued in VA

Practice address

3143 Magic Hollow Blvd Ste 100
Virginia Beach, VA 23453-3077

Phone

(757) 567-2868

Fax

(757) 368-3439

NPI assigned

Oct 13, 2022

Last updated

Oct 13, 2022By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

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": "1665619200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665619200000",
    "number": "1881310787",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5300 ELSTON LN",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234556892",
            "telephone_number": "757-305-6665"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3143 MAGIC HOLLOW BLVD STE 100",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234533077",
            "telephone_number": "757-567-2868",
            "fax_number": "757-368-3439"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5300 Elston Ln",
            "address_purpose": "LOCATION",
            "city": "Virginia Beach",
            "state": "VA",
            "postal_code": "234556892",
            "country_code": "US",
            "telephone_number": "757-305-6665",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BRADY",
        "first_name": "COLIN",
        "middle_name": "HUGH",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-10-13",
        "last_updated": "2022-10-13",
        "certification_date": "2022-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "VA",
            "license": "0701011782",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSED PROFESSIONAL COUNSELOR VA BOARD OF COUNSELING",
            "identifier": "0701011782",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kevin Bradley, SOIDC
• Randi Dawn Bradley, BS, LCMT, CRM, MMP
• Charles Jeremy Bradshaw, MPAS PA-C
• Erica Louise Bradshaw, MD
• Brady Christenson Family Dentistry (Town Center Family Dentisy, P.C.)
• Deanna Rose Brady, RBT
• Ashanti Bragg, BS, QMHP
• Kathryn G Bragg, PT
• Mark W Bragg, LPC
• Phyllis Bragg, MD

• Professional Counselor in Virginia Beach, VA
• Providers in Virginia Beach, VA by specialty
• Professional Counselor in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2022; 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.