Provider Demographics
NPI:1972042307
Name:FURZE, BRIANNA LEE (LLPC, CRC LMT)
Entity Type:Individual
Prefix:
First Name:BRIANNA
Middle Name:LEE
Last Name:FURZE
Suffix:
Gender:F
Credentials:LLPC, CRC LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4242 OAK FOREST CT SE
Mailing Address - Street 2:APT I-3
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49546-2409
Mailing Address - Country:US
Mailing Address - Phone:810-845-6208
Mailing Address - Fax:
Practice Address - Street 1:2305 E PARIS AVE SE
Practice Address - Street 2:SUITE 203
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49546-2426
Practice Address - Country:US
Practice Address - Phone:616-929-0226
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-02-17
Last Update Date:2017-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401014714101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional