| Brian Fanion, LMSW | |
|
3111 Electric Ave, Port Huron, MI 48060-8127 | |
| (810) 985-8900 | |
| Not Available |
| Full Name | Brian Fanion |
|---|---|
| Gender | Male |
| Speciality | Social Worker - Clinical |
| Location | 3111 Electric Ave, Port Huron, Michigan |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013223775 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 6801093156 (Michigan) | Primary |
| Entity Name | St Clair County Community Mental Health Authority |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1689783672 PECOS PAC ID: 7416861984 Enrollment ID: O20031118000783 |
| Entity Name | Norserv Group Ltd |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1619934650 PECOS PAC ID: 3577460047 Enrollment ID: O20031215000369 |
| Mailing Address | Practice Location Address |
|---|---|
| Brian Fanion, LMSW 3111 Electric Ave, Port Huron, MI 48060-8127 Ph: (810) 985-8900 | Brian Fanion, LMSW 3111 Electric Ave, Port Huron, MI 48060-8127 Ph: (810) 985-8900 |
Sara M Tavora, LMSW Clinical Social Worker Medicare: Accepting Medicare Assignments Practice Location: 520 Superior St, Port Huron, MI 48060 Phone: 810-984-4202 Fax: 810-984-8896 | |
Heather Stewart, LMSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 3111 Electric Ave, Port Huron, MI 48060 Phone: 810-985-8900 | |
Callie Gunn, Clinical Social Worker Medicare: Accepting Medicare Assignments Practice Location: 3111 Electric Ave, Port Huron, MI 48060 Phone: 810-985-8900 | |
Mr. Robert Marshall Ii, LMSW Clinical Social Worker Medicare: May Accept Medicare Assignments Practice Location: 3111 Electric Ave, Port Huron, MI 48060 Phone: 810-985-8900 | |
Kristen M Azzinaro, Clinical Social Worker Medicare: Accepting Medicare Assignments Practice Location: 3111 Electric Ave, Port Huron, MI 48060 Phone: 810-985-8900 | |
Mrs. Deborah Louise Kokoszka, LMSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 3111 Electric Ave, Port Huron, MI 48060 Phone: 810-985-8900 |