Provider Demographics
NPI:1164865440
Name:BRADY-PYNE, SANDRA DEAN ELIZABETH (LCSW, CASAC)
Entity type:Individual
Prefix:MRS
First Name:SANDRA DEAN
Middle Name:ELIZABETH
Last Name:BRADY-PYNE
Suffix:
Gender:F
Credentials:LCSW, CASAC
Other - Prefix:
Other - First Name:SANDRA
Other - Middle Name:
Other - Last Name:BRADY-PYNE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:3 COTTAGE PL
Mailing Address - Street 2:
Mailing Address - City:NEW ROCHELLE
Mailing Address - State:NY
Mailing Address - Zip Code:10801-4201
Mailing Address - Country:US
Mailing Address - Phone:914-235-6633
Mailing Address - Fax:914-633-3319
Practice Address - Street 1:3 COTTAGE PL
Practice Address - Street 2:
Practice Address - City:NEW ROCHELLE
Practice Address - State:NY
Practice Address - Zip Code:10801-4201
Practice Address - Country:US
Practice Address - Phone:914-235-6633
Practice Address - Fax:914-633-3319
Is Sole Proprietor?:No
Enumeration Date:2013-04-17
Last Update Date:2013-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY101YA0400X
NY070156-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)