Healthcare Provider Details

I. General information

NPI: 1851998298
Provider Name (Legal Business Name): KHARA BRIGNOLA LPCC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/08/2020
Last Update Date: 08/05/2026
Certification Date: 08/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1425 N FAIRFIELD RD STE 130
BEAVERCREEK OH
45432-2674
US

IV. Provider business mailing address

PO BOX 933421
CLEVELAND OH
44193-0039
US

V. Phone/Fax

Practice location:
  • Phone: 937-320-1950
  • Fax: 937-320-9332
Mailing address:
  • Phone: 937-641-5072
  • Fax: 937-641-6129

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberE.2606875
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: