Healthcare Provider Details

I. General information

NPI: 1811831639
Provider Name (Legal Business Name): BRITTNEY FETTERMAN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/14/2026
Last Update Date: 04/14/2026
Certification Date: 04/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7740 BYRON CENTER AVE SW STE 102
BYRON CENTER MI
49315-6929
US

IV. Provider business mailing address

28175 HAGGERTY RD
NOVI MI
48377-2903
US

V. Phone/Fax

Practice location:
  • Phone: 616-367-5813
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number6451024882
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: