Provider Demographics
NPI:1578340915
Name:BRINK, MEREDITH (MSW, LISW-S, PMH-C)
Entity Type:Individual
Prefix:
First Name:MEREDITH
Middle Name:
Last Name:BRINK
Suffix:
Gender:F
Credentials:MSW, LISW-S, PMH-C
Other - Prefix:
Other - First Name:MEREDITH
Other - Middle Name:
Other - Last Name:COLE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSW, LSW
Mailing Address - Street 1:1219 CHURCHBELL WAY
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43235-2158
Mailing Address - Country:US
Mailing Address - Phone:614-557-3377
Mailing Address - Fax:
Practice Address - Street 1:1460 MANNING PKWY
Practice Address - Street 2:
Practice Address - City:POWELL
Practice Address - State:OH
Practice Address - Zip Code:43065-9179
Practice Address - Country:US
Practice Address - Phone:614-383-8381
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-11
Last Update Date:2023-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI.15013271041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical