=====================================================
General NPI Number Information
=====================================================
NPI Number | 1811346612
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | JANET Z. BRINN, PSYD INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/13/2016
-----------------------------------------------------
Last Update Date | 03/10/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 9403 KENWOOD RD STE A204
-----------------------------------------------------
City | BLUE ASH
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 45242-6829
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 513-929-0935
-----------------------------------------------------
Fax | 513-492-8734
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 9403 KENWOOD RD STE A204
-----------------------------------------------------
City | BLUE ASH
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 45242-6829
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 513-929-0935
-----------------------------------------------------
Fax | 513-492-8734
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CLINICAL PSYCHOLOGIST
-----------------------------------------------------
Name | JANET Z BRINN
-----------------------------------------------------
Credential | PSYD
-----------------------------------------------------
Telephone | 513-489-8600
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 103TC0700X
-----------------------------------------------------
Taxonomy Name | Clinical Psychologist
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------