Provider Demographics
NPI:1952746596
Name:ANTROBIUS, BRIAN P (MA LPC)
Entity type:Individual
Prefix:
First Name:BRIAN
Middle Name:P
Last Name:ANTROBIUS
Suffix:
Gender:M
Credentials:MA 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 WASHTENAW AVE STE 222
Mailing Address - Street 2:
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48104-4261
Mailing Address - Country:US
Mailing Address - Phone:734-203-0183
Mailing Address - Fax:
Practice Address - Street 1:3300 WASHTENAW AVE STE 222
Practice Address - Street 2:
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48104-4261
Practice Address - Country:US
Practice Address - Phone:734-203-0183
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-09
Last Update Date:2024-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101Y00000X
MI6401014087101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101Y00000XBehavioral Health & Social Service ProvidersCounselor