MEDICARE: LINDA BRESETTE LLP

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	103T00000X	Psychologist	63610005140	MI

General Provider Information

NPI Number	:	1356202832
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LINDA BRESETTE LLP

Provider Business Mailing Address
First Line	:	5375 CRAIG RD
Second Line	:
City	:	STOCKBRIDGE
State	:	MI
Zip	:	49285-9549
Country	:	US
Telephone Number	:	313-643-2599
Fax Number	:

Provider Business Practice Location Address
First Line	:	800 W GRAND RIVER AVE STE 834
Second Line	:
City	:	BRIGHTON
State	:	MI
Zip	:	48116-2303
Country	:	US
Telephone Number	:	313-643-2599
Fax Number	:

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

Provider Enumeration Date	:	11/24/2025
Last Update Date	:	03/08/2026

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