Provider Demographics
NPI:1538623699
Name:BRILL-DYE, AUDREY (LISW-S)
Entity type:Individual
Prefix:
First Name:AUDREY
Middle Name:
Last Name:BRILL-DYE
Suffix:
Gender:F
Credentials:LISW-S
Other - Prefix:
Other - First Name:AUDREY
Other - Middle Name:
Other - Last Name:BRILL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:700 CHILDRENS DR
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43205-2664
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:444 BUTTERFLY GARDENS DR
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43215-3427
Practice Address - Country:US
Practice Address - Phone:614-938-9278
Practice Address - Fax:614-938-0240
Is Sole Proprietor?:No
Enumeration Date:2019-01-23
Last Update Date:2024-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI.2103316-SUPV1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical