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General NPI Number Information
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NPI Number | 1740409697
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Entity Type | Individual
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Provider Name | BRIAN JAMES NASSAR LPC
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Gender | Male
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Dates
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Enumeration Date | 04/25/2007
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Last Update Date | 01/28/2025
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Provider Practice Location Address
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Address Line | 44725 GRAND RIVER AVE STE 104
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City | NOVI
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State | MI
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Zip | 48375-1024
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Country | US
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Telephone | 517-492-0784
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Fax |
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Provider Business Mailing Address
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Address Line | 1110 ELDON BAKER DR
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City | FLINT
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State | MI
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Zip | 48507-1923
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Country | US
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Telephone | 810-213-1803
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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 | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 6401018208
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License Number State | MI
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