Provider Demographics
NPI:1346493194
Name:BRINSKO PSYCHOLOGICAL SERVICES INC
Entity Type:Organization
Organization Name:BRINSKO PSYCHOLOGICAL SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:BETH
Authorized Official - Middle Name:ELLEN
Authorized Official - Last Name:BRINSKO
Authorized Official - Suffix:
Authorized Official - Credentials:PH D
Authorized Official - Phone:859-283-2892
Mailing Address - Street 1:7430 US HIGHWAY 42
Mailing Address - Street 2:SUITE 118
Mailing Address - City:FLORENCE
Mailing Address - State:KY
Mailing Address - Zip Code:41042-1989
Mailing Address - Country:US
Mailing Address - Phone:859-283-2892
Mailing Address - Fax:859-283-2897
Practice Address - Street 1:7430 US HIGHWAY 42
Practice Address - Street 2:SUITE 118
Practice Address - City:FLORENCE
Practice Address - State:KY
Practice Address - Zip Code:41042-1989
Practice Address - Country:US
Practice Address - Phone:859-283-2892
Practice Address - Fax:859-283-2897
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-24
Last Update Date:2008-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY833251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY8897Medicare UPIN