Provider Demographics
NPI:1477982148
Name:BRZEZINSKI, SARA ANN (LPC)
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:ANN
Last Name:BRZEZINSKI
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3300 VAN BUREN ST
Mailing Address - Street 2:
Mailing Address - City:HUDSONVILLE
Mailing Address - State:MI
Mailing Address - Zip Code:49426-1132
Mailing Address - Country:US
Mailing Address - Phone:616-662-3300
Mailing Address - Fax:
Practice Address - Street 1:3300 VAN BUREN ST
Practice Address - Street 2:
Practice Address - City:HUDSONVILLE
Practice Address - State:MI
Practice Address - Zip Code:49426-1132
Practice Address - Country:US
Practice Address - Phone:616-662-3300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-11-04
Last Update Date:2016-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401011182101YP2500X
247200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional