Healthcare Provider Details

I. General information

NPI: 1497669683
Provider Name (Legal Business Name): JOSHUA R VERBRUGGEN
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/02/2026
Last Update Date: 10/02/2026
Certification Date: 10/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1114 W BRISTOL RD
FLINT MI
48507-5518
US

IV. Provider business mailing address

1116 W BRISTOL RD
FLINT MI
48507-5518
US

V. Phone/Fax

Practice location:
  • Phone: 810-232-7919
  • Fax: 810-232-7913
Mailing address:
  • Phone: 810-232-7919
  • Fax: 810-232-7913

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: