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General NPI Number Information
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NPI Number | 1649902701
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Entity Type | Individual
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Provider Name | OLIVIA BRENNINKMEIJER MA, LPC, NCC
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Gender | Female
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Dates
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Enumeration Date | 06/28/2022
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Last Update Date | 02/03/2026
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Provider Practice Location Address
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Address Line | 4829 E BELTLINE AVE NE STE 302
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City | GRAND RAPIDS
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State | MI
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Zip | 49525-9350
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Country | US
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Telephone | 616-226-6522
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Fax |
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Provider Business Mailing Address
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Address Line | 2717 MAPLEWOOD DR SE
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City | EAST GRAND RAPIDS
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State | MI
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Zip | 49506-4729
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Country | US
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Telephone | 231-866-1160
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 6401225492
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License Number State | MI
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