Provider Demographics
NPI:1922738392
Name:RAYFORD, BRETT SCOTT (PSYD)
Entity Type:Individual
Prefix:DR
First Name:BRETT
Middle Name:SCOTT
Last Name:RAYFORD
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1824 RICHTREE RD
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43219-1651
Mailing Address - Country:US
Mailing Address - Phone:203-645-3156
Mailing Address - Fax:
Practice Address - Street 1:5965 E BROAD ST STE 350
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43213-1533
Practice Address - Country:US
Practice Address - Phone:203-645-3156
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-16
Last Update Date:2022-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT001715103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical