Basic Information
| Provider Information | |||||||||
| NPI: | 1265052138 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BRASHEAR | ||||||||
| FirstName: | STEPHANIE | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | MS. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.A., LPCC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1943 W 5TH AVE | ||||||||
| Address2: | |||||||||
| City: | COLUMBUS | ||||||||
| State: | OH | ||||||||
| PostalCode: | 432121902 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6143055102 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 287 W JOHNSTOWN RD | ||||||||
| Address2: | |||||||||
| City: | COLUMBUS | ||||||||
| State: | OH | ||||||||
| PostalCode: | 432302732 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6143055102 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/21/2020 | ||||||||
| LastUpdateDate: | 12/19/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 12/19/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YP2500X | 7427 | SC | N | Behavioral Health & Social Service Providers | Counselor | Professional | 101YM0800X | E.2001925 | OH | Y | Behavioral Health & Social Service Providers | Counselor | Mental Health |
No ID Information.