| Brandon Robert Peter Mielke, PHD, LPC, NCC, CAADC | |
|
1982 E Mitchell Rd, Petoskey, MI 49770-9603 | |
| (231) 622-5800 | |
| Not Available |
| Full Name | Brandon Robert Peter Mielke |
|---|---|
| Gender | Male |
| Speciality | Counselor - Professional |
| Location | 1982 E Mitchell Rd, Petoskey, Michigan |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1760004907 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | 6401223756 (Michigan) | Primary |
| Entity Name | Walloon Lake Recovery Lodge, Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1750791505 PECOS PAC ID: 6901341155 Enrollment ID: O20240711002303 |
| Mailing Address | Practice Location Address |
|---|---|
| Brandon Robert Peter Mielke, PHD, LPC, NCC, CAADC 3670 N Lynn St, Onaway, MI 49765-8914 Ph: (586) 337-5800 | Brandon Robert Peter Mielke, PHD, LPC, NCC, CAADC 1982 E Mitchell Rd, Petoskey, MI 49770-9603 Ph: (231) 622-5800 |
Matthew Mckelvey, CADC-D Counselor Medicare: Not Enrolled in Medicare Practice Location: 704 Emmet St, Petoskey, MI 49770 Phone: 231-347-5511 | |
Roy Lee Angel Jr., Counselor Medicare: Not Enrolled in Medicare Practice Location: 704 Emmet St, Petoskey, MI 49770 Phone: 231-347-5511 Fax: 231-347-5422 | |
Mr. Mason Sylar Valor, PHD, LPC, CAADC Counselor Medicare: Accepting Medicare Assignments Practice Location: 1260 Ajijaak Ave, Petoskey, MI 49770 Phone: 231-242-1640 | |
Marissa Sweeney, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 2236 E Mitchell Rd # 5, Petoskey, MI 49770 Phone: 231-622-3494 | |
Maureen Todd, Counselor Medicare: Not Enrolled in Medicare Practice Location: 703 Emmet St, Petoskey, MI 49770 Phone: 231-347-5511 | |
Mrs. Adrienne Josephine Shiels, LLMSW Counselor Medicare: Medicare Enrolled Practice Location: 2202 Mitchell Park Dr Ste 2b, Petoskey, MI 49770 Phone: 231-487-2215 | |
Jean Moree, LPC, NCC, CCTS-I Counselor Medicare: Accepting Medicare Assignments Practice Location: 3890 Charlevoix Rd Ste 304, Petoskey, MI 49770 Phone: 231-486-5434 Fax: 877-406-2565 |