Provider Demographics
NPI:1871033241
Name:BRUGMANSIA COUNSELING GROUP PLLC
Entity Type:Organization
Organization Name:BRUGMANSIA COUNSELING GROUP PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COUNSELOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:CHARLA
Authorized Official - Middle Name:EVONNE
Authorized Official - Last Name:ADAMS
Authorized Official - Suffix:
Authorized Official - Credentials:MA LLPC
Authorized Official - Phone:248-987-7996
Mailing Address - Street 1:25882 ORCHARD LAKE RD
Mailing Address - Street 2:SUITE L-7A
Mailing Address - City:FARMINGTON HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48336-1292
Mailing Address - Country:US
Mailing Address - Phone:248-987-7996
Mailing Address - Fax:
Practice Address - Street 1:25882 ORCHARD LAKE RD
Practice Address - Street 2:SUITE L-7A
Practice Address - City:FARMINGTON HILLS
Practice Address - State:MI
Practice Address - Zip Code:48336-1292
Practice Address - Country:US
Practice Address - Phone:248-987-7996
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-03
Last Update Date:2017-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401015961261QM0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)