Healthcare Provider Details

I. General information

NPI: 1679088926
Provider Name (Legal Business Name): BRITTANY ZUKOWSKI MS, MA, LMFT, LLPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: BRITTANY BUDA

II. Dates (important events)

Enumeration Date: 12/08/2017
Last Update Date: 06/29/2021
Certification Date: 06/29/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

92 N BRIDGE ST
SARANAC MI
48881-5102
US

IV. Provider business mailing address

7279 BLAKELY DR NE
ROCKFORD MI
49341-9488
US

V. Phone/Fax

Practice location:
  • Phone: 616-642-6466
  • Fax:
Mailing address:
  • Phone: 616-439-1077
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number6401016391
License Number StateMI
# 2
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number4101007144
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: