Provider Demographics
NPI:1093087751
Name:MCPHERSON, DEWAN BRANDLL (LLPC)
Entity Type:Individual
Prefix:MS
First Name:DEWAN
Middle Name:BRANDLL
Last Name:MCPHERSON
Suffix:
Gender:F
Credentials:LLPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3559 ORIOLE DR
Mailing Address - Street 2:
Mailing Address - City:TROY
Mailing Address - State:MI
Mailing Address - Zip Code:48084-1618
Mailing Address - Country:US
Mailing Address - Phone:248-376-0679
Mailing Address - Fax:248-269-6055
Practice Address - Street 1:101 W. LOOMIS STREET
Practice Address - Street 2:
Practice Address - City:LUDINGTON
Practice Address - State:MI
Practice Address - Zip Code:49431-2091
Practice Address - Country:US
Practice Address - Phone:231-233-1655
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-27
Last Update Date:2012-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401012845101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional