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NPI Code Detail

MEDICARE: MS. BERNIE ELEANOR KOMRAUS LPC, CAC II

MEDICARE: MS. BERNIE ELEANOR KOMRAUS LPC, CAC II
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YA0400XAddiction (Substance Use Disorder) Counselor2-00693MI
2101YM0800XMental Health Counselor6401007208MI

General Provider Information

NPI Number : 1447271424
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. BERNIE ELEANOR KOMRAUS LPC, CAC II
Provider Business Mailing Address
First Line : 114 ORCHARD LAKE RD
Second Line :
City : PONTIAC
State : MI
Zip : 48341-2244
Country : US
Telephone Number : 248-858-7766
Fax Number : 248-858-8227
Provider Business Practice Location Address
First Line : 114 ORCHARD LAKE RD
Second Line :
City : PONTIAC
State : MI
Zip : 48341-2244
Country : US
Telephone Number : 248-858-7766
Fax Number : 248-858-8227
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/22/2006
Last Update Date : 09/11/2025

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