Provider Demographics
NPI:1437624517
Name:BRIXIUS, THERESA LYNN (LPC)
Entity Type:Individual
Prefix:
First Name:THERESA
Middle Name:LYNN
Last Name:BRIXIUS
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:671 COLUMBIA RD STE 8
Mailing Address - Street 2:
Mailing Address - City:WESTLAKE
Mailing Address - State:OH
Mailing Address - Zip Code:44145-1477
Mailing Address - Country:US
Mailing Address - Phone:440-895-0366
Mailing Address - Fax:
Practice Address - Street 1:671 COLUMBIA RD STE 8
Practice Address - Street 2:
Practice Address - City:WESTLAKE
Practice Address - State:OH
Practice Address - Zip Code:44145-1477
Practice Address - Country:US
Practice Address - Phone:440-895-0366
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-04
Last Update Date:2023-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE2102570101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHC1801425OtherLPC LICENSE