| Marissa Brandenburg, LPC | |
|
3255 Pontaluna Rd, Fruitport, MI 49415 | |
| (231) 733-6720 | |
| Not Available |
| Full Name | Marissa Brandenburg |
|---|---|
| Gender | Female |
| Speciality | Counselor - Mental Health |
| Location | 3255 Pontaluna Rd, Fruitport, Michigan |
| Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114309796 | NPI | - | NPPES |
| 1114309796 | Medicaid | MI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | 6401014770 (Michigan) | Primary |
| Mailing Address | Practice Location Address |
|---|---|
| Marissa Brandenburg, LPC 2700 Baker St Fl 3, Muskegon, MI 49444-2157 Ph: (231) 737-1335 | Marissa Brandenburg, LPC 3255 Pontaluna Rd, Fruitport, MI 49415 Ph: (231) 733-6720 |
Marykay Radford, Counselor Medicare: Not Enrolled in Medicare Practice Location: 3285 S Broton Rd, Fruitport, MI 49415 Phone: 231-739-4359 Fax: 231-733-6151 | |
Mr. James Sherrill, Counselor Medicare: Not Enrolled in Medicare Practice Location: 6250 Cline Rd, Fruitport, MI 49415 Phone: 231-213-0923 |