Provider Demographics
NPI:1659558633
Name:FRIAS, BRANDYN LYNN (LSW)
Entity Type:Individual
Prefix:MRS
First Name:BRANDYN
Middle Name:LYNN
Last Name:FRIAS
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3453 BREMEN ST
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43224-3434
Mailing Address - Country:US
Mailing Address - Phone:614-261-1667
Mailing Address - Fax:
Practice Address - Street 1:513 E RICH ST
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43215-5376
Practice Address - Country:US
Practice Address - Phone:614-573-8690
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-22
Last Update Date:2008-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHS29587104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker