Provider Demographics
NPI:1144415522
Name:MAJERCZYK, BRIAN (MA, LLP)
Entity Type:Individual
Prefix:MR
First Name:BRIAN
Middle Name:
Last Name:MAJERCZYK
Suffix:
Gender:M
Credentials:MA, LLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:512 S UNION ST
Mailing Address - Street 2:
Mailing Address - City:TRAVERSE CITY
Mailing Address - State:MI
Mailing Address - Zip Code:49684-3247
Mailing Address - Country:US
Mailing Address - Phone:231-941-6550
Mailing Address - Fax:231-941-8981
Practice Address - Street 1:512 S UNION ST
Practice Address - Street 2:
Practice Address - City:TRAVERSE CITY
Practice Address - State:MI
Practice Address - Zip Code:49684-3247
Practice Address - Country:US
Practice Address - Phone:231-941-6550
Practice Address - Fax:231-941-8981
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-10
Last Update Date:2007-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6301011568103TB0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & Behavioral