Healthcare Provider Details

I. General information

NPI: 1942110440
Provider Name (Legal Business Name): MR. BRETT PAGE
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/09/2026
Last Update Date: 09/09/2026
Certification Date: 09/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

499 E WEISHEIMER RD
COLUMBUS OH
43214-2238
US

IV. Provider business mailing address

499 E WEISHEIMER RD
COLUMBUS OH
43214-2238
US

V. Phone/Fax

Practice location:
  • Phone: 614-365-6001
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License NumberLSP.02851
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: