Healthcare Provider Details

I. General information

NPI: 1528981073
Provider Name (Legal Business Name): BRENDA ALICIA GEORGES LLPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/03/2026
Last Update Date: 08/03/2026
Certification Date: 08/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3456 PIERSON PL
FLUSHING MI
48433-2474
US

IV. Provider business mailing address

7146 TIMBERLINE DR
FLINT MI
48507-0520
US

V. Phone/Fax

Practice location:
  • Phone: 810-875-1076
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number6451023186
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: