Provider Demographics
NPI:1457142788
Name:STEIN, BROOK TAYLOR
Entity type:Individual
Prefix:
First Name:BROOK
Middle Name:TAYLOR
Last Name:STEIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2755 STATE ROUTE 132 LOT 10
Mailing Address - Street 2:
Mailing Address - City:NEW RICHMOND
Mailing Address - State:OH
Mailing Address - Zip Code:45157-9749
Mailing Address - Country:US
Mailing Address - Phone:513-646-7688
Mailing Address - Fax:
Practice Address - Street 1:25 WHITNEY DR STE 120
Practice Address - Street 2:
Practice Address - City:MILFORD
Practice Address - State:OH
Practice Address - Zip Code:45150-8400
Practice Address - Country:US
Practice Address - Phone:513-654-2773
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-15
Last Update Date:2025-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH192565101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)