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NPI Code Detail

MEDICARE: MS. ALLISON BEZRUCZKO MA, LPC

MEDICARE: MS. ALLISON BEZRUCZKO MA, LPC
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
1101YM0800XMental Health Counselor6401010490MI

General Provider Information

NPI Number : 1528266913
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. ALLISON BEZRUCZKO MA, LPC
Provider Business Mailing Address
First Line : 44899 CENTRE CT STE 102
Second Line :
City : CLINTON TOWNSHIP
State : MI
Zip : 48038-5510
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 44899 CENTRE CT STE 102
Second Line :
City : CLINTON TOWNSHIP
State : MI
Zip : 48038-5510
Country : US
Telephone Number : 586-792-1654
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/06/2007
Last Update Date : 08/12/2022

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