| Jennifer Bazner, Ma, Lpc Llc | |
|
4829 E Beltline Ave Ne Bldg 1 Grand Rapids MI 49525-9747 | |
| (616) 446-1117 | |
| Not Available |
| Full Name | Jennifer Bazner, Ma, Lpc Llc |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 4829 E Beltline Ave Ne Bldg 1, Grand Rapids, Michigan |
| Authorized Official Name and Position | Jennifer L Bazner (THERAPIST/OWNER) |
| Authorized Official Contact | 6164461117 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Jennifer Bazner, Ma, Lpc Llc 4829 E Beltline Ave Ne Bldg 1 Grand Rapids MI 49525-9747 Ph: (616) 446-1117 | Jennifer Bazner, Ma, Lpc Llc 4829 E Beltline Ave Ne Bldg 1 Grand Rapids MI 49525-9747 Ph: (616) 446-1117 |
| NPI Number | 1750943262 |
|---|---|
| Provider Enumeration Date | 07/03/2019 |
| Last Update Date | 07/03/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1750943262 | NPI | - | NPPES |
| 1417134453 | Medicaid | MI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
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