Healthcare Provider Details

I. General information

NPI: 1558224667
Provider Name (Legal Business Name): BREIONA ELAINE GOLDEN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/05/2025
Last Update Date: 09/25/2026
Certification Date: 09/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2256 CLEVELAND AVE
COLUMBUS OH
43211-2276
US

IV. Provider business mailing address

2619 CASTINE WAY
REYNOLDSBURG OH
43068-4162
US

V. Phone/Fax

Practice location:
  • Phone: 614-598-0328
  • Fax:
Mailing address:
  • Phone: 220-246-3905
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TE1100X
TaxonomyExercise & Sports Psychologist
License Number
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateOH
# 3
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: