| Benjamin Braaksma | |
|
1115 Bethel Rd Columbus OH 43220-2690 | |
| (206) 945-0648 | |
| (206) 834-6734 |
| Full Name | Benjamin Braaksma |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 1115 Bethel Rd, Columbus, Ohio |
| Authorized Official Name and Position | Benjamin Braaksma (OWNER) |
| Authorized Official Contact | 2069450648 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Benjamin Braaksma 1115 Bethel Rd Columbus OH 43220-2690 Ph: (206) 945-0648 | Benjamin Braaksma 1115 Bethel Rd Columbus OH 43220-2690 Ph: (206) 945-0648 |
| NPI Number | 1295358901 |
|---|---|
| Provider Enumeration Date | 05/28/2020 |
| Last Update Date | 09/24/2024 |
| Certification Date | 09/24/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1295358901 | NPI | - | NPPES |
| LH60891645 | Other | WA | LICENSE |
| E.2303894 | Other | OH | LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
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