Provider Demographics
NPI:1699128249
Name:COLLINS, BRANDI ROSE (LPC)
Entity type:Individual
Prefix:MRS
First Name:BRANDI
Middle Name:ROSE
Last Name:COLLINS
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:MS
Other - First Name:BRANDI
Other - Middle Name:ROSE
Other - Last Name:YOUNG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPC
Mailing Address - Street 1:1791 ALUM CREEK DR
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43207-1708
Mailing Address - Country:US
Mailing Address - Phone:614-445-8131
Mailing Address - Fax:614-827-8380
Practice Address - Street 1:88 N. SANDUSKY ST.
Practice Address - Street 2:
Practice Address - City:DELAWARE
Practice Address - State:OH
Practice Address - Zip Code:43015
Practice Address - Country:US
Practice Address - Phone:740-203-3800
Practice Address - Fax:740-203-3799
Is Sole Proprietor?:No
Enumeration Date:2016-07-19
Last Update Date:2016-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHC.1300504101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional