| Samuel Lewis Brode, LPC | |
|
801 Hazen St Ste C, Paw Paw, MI 49079-2008 | |
| (269) 657-5574 | |
| (269) 657-6523 |
| Full Name | Samuel Lewis Brode |
|---|---|
| Gender | Male |
| Speciality | Counselor - Mental Health |
| Location | 801 Hazen St Ste C, Paw Paw, Michigan |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1780351122 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | 6401019495 (Michigan) | Primary |
| Entity Name | Van Buren Community Mental Health Authority |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1003878554 PECOS PAC ID: 6800863788 Enrollment ID: O20040910000867 |
| Mailing Address | Practice Location Address |
|---|---|
| Samuel Lewis Brode, LPC Po Box 249, Paw Paw, MI 49079-0249 Ph: (269) 657-5574 | Samuel Lewis Brode, LPC 801 Hazen St Ste C, Paw Paw, MI 49079-2008 Ph: (269) 657-5574 |
Nicole Alayna Douglass, MA, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 816 E Michigan Ave Ste 103, Paw Paw, MI 49079 Phone: 269-815-8169 | |
Andrina Jordan, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 801 Hazen St, Paw Paw, MI 49079 Phone: 269-655-3334 Fax: 269-657-6523 | |
Rachel Rose Robertson, MA, LLPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 801 Hazen St Ste C, Paw Paw, MI 49079 Phone: 269-657-5574 | |
Jason Vanlester, M.A, Counselor Medicare: Not Enrolled in Medicare Practice Location: 232 E Michigan Ave, Paw Paw, MI 49079 Phone: 269-870-6919 | |
Miss Julie Ann Strong, L.L.P., C.A.A.D.C. Counselor Medicare: Not Enrolled in Medicare Practice Location: 801 Hazen St, Paw Paw, MI 49079 Phone: 269-655-3394 Fax: 269-655-1557 | |
Elizabeth May Headley, LLPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 801 Hazen St Ste C, Paw Paw, MI 49079 Phone: 269-655-3356 | |
Aaron Bronsink, LLPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 181 W Michigan Ave, Suite 2, Paw Paw, MI 49079 Phone: 269-858-8230 |