Provider Demographics
NPI:1396963252
Name:FUJII, BRIAN KEN (LPC, MAC, NCC)
Entity type:Individual
Prefix:MR
First Name:BRIAN
Middle Name:KEN
Last Name:FUJII
Suffix:
Gender:M
Credentials:LPC, MAC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1403 60TH ST SE
Mailing Address - Street 2:
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49508-7065
Mailing Address - Country:US
Mailing Address - Phone:616-805-3660
Mailing Address - Fax:
Practice Address - Street 1:1403 60TH ST SE
Practice Address - Street 2:
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49508-7065
Practice Address - Country:US
Practice Address - Phone:616-805-3360
Practice Address - Fax:616-805-3631
Is Sole Proprietor?:No
Enumeration Date:2007-04-23
Last Update Date:2020-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC001422101YP2500X
MI6401018346101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI6401018346OtherLPC LICENSE NUMBER
GALPC001422OtherLPC LICENSE NUMBER