Provider Demographics
NPI:1043581911
Name:BRENNEMAN, VALERIE ANNE (LPC)
Entity Type:Individual
Prefix:MRS
First Name:VALERIE
Middle Name:ANNE
Last Name:BRENNEMAN
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:MS
Other - First Name:VALERIE
Other - Middle Name:ANNE
Other - Last Name:SWISHER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1405 FARMRIDGE
Mailing Address - Street 2:
Mailing Address - City:WATERFORD
Mailing Address - State:MI
Mailing Address - Zip Code:48328
Mailing Address - Country:US
Mailing Address - Phone:248-785-7208
Mailing Address - Fax:
Practice Address - Street 1:5745 W. MAPLE RD.
Practice Address - Street 2:SUITE 202
Practice Address - City:WEST BLOOMFIELD
Practice Address - State:MI
Practice Address - Zip Code:48322
Practice Address - Country:US
Practice Address - Phone:248-862-5110
Practice Address - Fax:844-893-1355
Is Sole Proprietor?:No
Enumeration Date:2012-01-24
Last Update Date:2020-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YP2500X
MI6401013071101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0138278Medicaid