Provider Demographics
NPI:1407471733
Name:FLORY, BRENT (LPCC)
Entity Type:Individual
Prefix:
First Name:BRENT
Middle Name:
Last Name:FLORY
Suffix:
Gender:M
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1491 POLARIS PKWY STE 44
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43240-2041
Mailing Address - Country:US
Mailing Address - Phone:614-210-3815
Mailing Address - Fax:
Practice Address - Street 1:20 NORTHWOODS BLVD STE B1
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43235-4729
Practice Address - Country:US
Practice Address - Phone:614-210-3815
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-12
Last Update Date:2023-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE.2303660101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health