Healthcare Provider Details

I. General information

NPI: 1780326934
Provider Name (Legal Business Name): BRENNERHELP LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/08/2022
Last Update Date: 06/10/2026
Certification Date: 06/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

268 E KILGORE RD STE B
PORTAGE MI
49002-1104
US

IV. Provider business mailing address

2722 E MICHIGAN AVE STE 238
LANSING MI
48912-4014
US

V. Phone/Fax

Practice location:
  • Phone: 517-420-0394
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: AMY GREENHOE
Title or Position: CREDENTIALING
Credential:
Phone: 517-888-3520