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NPI Code Detail

MEDICARE: MS. KAREN BRICKNER M.A.

MEDICARE: MS. KAREN BRICKNER M.A.
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
1103TC0700XClinical Psychologist6361008221MI
2103T00000XPsychologist6361006221MI

General Provider Information

NPI Number : 1912010315
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. KAREN BRICKNER M.A.
Provider Business Mailing Address
First Line : 632 DORCHESTER DR
Second Line : APT 194
City : ROCHESTER HILLS
State : MI
Zip : 48307-4029
Country : US
Telephone Number : 248-844-8161
Fax Number :
Provider Business Practice Location Address
First Line : 1501 KRAFFT RD
Second Line :
City : FORT GRATIOT
State : MI
Zip : 48059-3565
Country : US
Telephone Number : 810-985-5125
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/17/2006
Last Update Date : 12/02/2025

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