Provider Demographics
NPI:1780638338
Name:BRINSKO, BETH E (PHD)
Entity Type:Individual
Prefix:DR
First Name:BETH
Middle Name:E
Last Name:BRINSKO
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:75 CAVALIER BLVD STE 300
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:KY
Mailing Address - Zip Code:41042-3950
Mailing Address - Country:US
Mailing Address - Phone:859-283-2892
Mailing Address - Fax:859-283-2897
Practice Address - Street 1:75 CAVALIER BLVD STE 300
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:KY
Practice Address - Zip Code:41042-3950
Practice Address - Country:US
Practice Address - Phone:859-283-2892
Practice Address - Fax:859-283-2897
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-19
Last Update Date:2009-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY0833103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
089418000OtherMAGELLAN MIS
KY22000000019998OtherANTHEM PROV. NUMBER
1467OtherALLIANCE BEHAVIORAL CARE