Healthcare Provider Details

I. General information

NPI: 1396298808
Provider Name (Legal Business Name): CHRISTOPHER BRUMM M.A.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/01/2016
Last Update Date: 12/24/2025
Certification Date: 12/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2413 BOSTON BLVD
LANSING MI
48910-2466
US

IV. Provider business mailing address

2413 BOSTON BLVD
LANSING MI
48910-2466
US

V. Phone/Fax

Practice location:
  • Phone: 517-798-6978
  • Fax:
Mailing address:
  • Phone: 517-289-8180
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-17-25546
License Number StateMI
# 2
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number7401000181
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: