MEDICARE: STACEY BROTHERS PHD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103T00000X	Psychologist

General Provider Information

NPI Number	:	1891643680
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STACEY BROTHERS PHD

Provider Business Mailing Address
First Line	:	3650 OLENTANGY RIVER RD STE 310
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43214-3654
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3650 OLENTANGY RIVER RD STE 310
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43214-3654
Country	:	US
Telephone Number	:	614-293-9600
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/18/2026
Last Update Date	:	03/18/2026

Similar Medicare Providers

1003137688 — DR. JUSTIN C BAKER PHD, ABPP
Practice Location Address:

3650 OLENTANGY RIVER RD STE 310
COLUMBUS, OH
43214-3654

Practice Phone: 614-257-2069
Practice Fax:

1396080420 — CHRISTI TRASK
Practice Location Address:

3650 OLENTANGY RIVER RD STE 310
COLUMBUS, OH
43214-3654

Practice Phone: 614-293-9600
Practice Fax:

1568197937 — DR. JARYD HISER PH.D.
Practice Location Address:

3650 OLENTANGY RIVER RD STE 310
COLUMBUS, OH
43214-3654

Practice Phone: 614-293-9600
Practice Fax:

1528165248 — SOUTHERN DRUGS, INC
Practice Location Address:

3654 NEW HOPE RD
COLUMBUS, MS
39702-8521

Practice Phone: 662-328-8028
Practice Fax: 662-328-3149

1679724082 — DUTCH PHARMACIES INC
Practice Location Address:

3654 NEW HOPE RD
COLUMBUS, MS
39702-8521

Practice Phone: 662-328-8028
Practice Fax: 662-328-3149

1275885402 — MS. JULIANA AGYEI HOWARD LPN
Practice Location Address:

4132 VINESHIRE LN
COLUMBUS, OH
43227-3654

Practice Phone: 614-446-2479
Practice Fax:

Directions to “ STACEY BROTHERS PHD” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.