Healthcare Provider Details

I. General information

NPI: 1477418119
Provider Name (Legal Business Name): JULIE ANNE BRINKMAN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/16/2025
Last Update Date: 12/16/2025
Certification Date: 12/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

810 S CABLE RD
LIMA OH
45805-3468
US

IV. Provider business mailing address

15259 ROAD 18
FORT JENNINGS OH
45844-9762
US

V. Phone/Fax

Practice location:
  • Phone: 419-969-3125
  • Fax:
Mailing address:
  • Phone: 513-509-8293
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: