Brian Brown
Individual provider Active NPI Peer Specialist · Blacklick, OH
NPI 1245015643 · NPPES record last updated Aug 25, 2023
Key facts
- NPI
- 1245015643
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Peer Specialist 175T00000X
- Practice address
- 712 Loreto LN
Blacklick, OH 43004-8365 - Phone
- (614) 804-2192
- NPI assigned
- Aug 25, 2023
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Peer Specialist | 175T00000X | OH | Yes |
Addresses
Primary practice location
712 Loreto LN
Blacklick, OH 43004-8365
Mailing address
712 Loreto LN
Blacklick, OH 43004-8365
Phone (614) 804-2192
Other providers in Blacklick, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 25, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.