MEDICARE: BREEYN NICOLE MAXWELL MA, LPC, CAADC

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	101YM0800X	Mental Health Counselor	6301015970	MI

General Provider Information

NPI Number	:	1558747055
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BREEYN NICOLE MAXWELL MA, LPC, CAADC

Provider Business Mailing Address
First Line	:	1538 TAMARACK AVE NW
Second Line	:
City	:	GRAND RAPIDS
State	:	MI
Zip	:	49504-3041
Country	:	US
Telephone Number	:	810-334-0506
Fax Number	:

Provider Business Practice Location Address
First Line	:	1971 E BELTLINE AVE NE STE 106
Second Line	:
City	:	GRAND RAPIDS
State	:	MI
Zip	:	49525-7045
Country	:	US
Telephone Number	:	616-666-6904
Fax Number	:

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

Provider Enumeration Date	:	08/06/2015
Last Update Date	:	03/19/2024

Similar Medicare Providers

1871871350 — CLM ENTERPRISES, INC.
Practice Location Address:

1971 E BELTLINE AVE NE , SUITE 225
GRAND RAPIDS, MI
49525-7045

Practice Phone: 616-719-2928
Practice Fax: 616-575-1322

1114290517 — 139 EDUCATION, LLC
Practice Location Address:

1971 E BELTLINE AVE NE , SUITE 212
GRAND RAPIDS, MI
49525-7045

Practice Phone: 800-600-4096
Practice Fax:

1538594015 — DEBRA SUE ANSON LMSW, RAC
Practice Location Address:

1971 E BELTLINE AVE NE STE 106
GRAND RAPIDS, MI
49525-7045

Practice Phone: 616-268-2787
Practice Fax:

1366854283 — MARY LAFRAMBOISE
Practice Location Address:

1971 E BELTLINE AVE NE STE A
GRAND RAPIDS, MI
49525-7045

Practice Phone: 616-439-1135
Practice Fax:

1245787241 — DR. NATALIE WAYBRANT LMFT
Practice Location Address:

1971 E BELTLINE AVE NE STE 200-C
GRAND RAPIDS, MI
49525-7045

Practice Phone: 616-344-1344
Practice Fax: 616-344-1100

1699210120 — CLM ENTERPRISES INC.
Practice Location Address:

1971 E BELTLINE AVE NE , SUITE 225
GRAND RAPIDS, MI
49525-7045

Practice Phone: 616-719-2928
Practice Fax: 616-575-1322

Directions to “ BREEYN NICOLE MAXWELL MA, LPC, CAADC” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.