MEDICARE: RANDALL BRASMER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YA0400X	Addiction (Substance Use Disorder) Counselor

General Provider Information

NPI Number	:	1053789818
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RANDALL BRASMER

Provider Business Mailing Address
First Line	:	32 S MACDONALD
Second Line	:
City	:	MESA
State	:	AZ
Zip	:	85210-1310
Country	:	US
Telephone Number	:	480-969-1471
Fax Number	:	480-264-0687

Provider Business Practice Location Address
First Line	:	32 S MACDONALD
Second Line	:
City	:	MESA
State	:	AZ
Zip	:	85210-1310
Country	:	US
Telephone Number	:	480-969-1471
Fax Number	:	480-264-0687

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/10/2015
Last Update Date	:	03/08/2026

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Directions to “ RANDALL BRASMER ” Practice Location

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