Brenden Arias Tudor, LLPC, AT

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

6401018626 Issued in MI

Practice address

1611 Oak Ave
Muskegon, MI 49442-2468

Phone

(231) 767-1921

NPI assigned

Mar 10, 2016

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1457568000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605484800000",
    "number": "1003277674",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1611 OAK AVE",
            "city": "MUSKEGON",
            "state": "MI",
            "postal_code": "494422468",
            "telephone_number": "231-767-1921"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1611 OAK AVE",
            "city": "MUSKEGON",
            "state": "MI",
            "postal_code": "494422468",
            "telephone_number": "231-767-1921"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TUDOR",
        "first_name": "BRENDEN",
        "middle_name": "ARIAS",
        "credential": "LLPC, AT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-03-10",
        "last_updated": "2020-11-16",
        "certification_date": "2020-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "MI",
            "license": "2601001963",
            "primary": false
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MI",
            "license": "6401018626",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Maxwell Trombly, PHARMD
• Karissa Leah Tryska, DO
• David C Tsai, DO
• Jason Mark Tucker, PA-C
• Avanthi Yasundara Tudor, M.D.
• Jenna Ann Tudor, PHYSICIAN ASSISTANT
• Debra Lyn Tufts, MA, EDS, LLP
• Kimberly R Tullock, M.A. - CCC-A
• Kyle Nathaniel Turcic, MD
• Alexandria Michelle Turner

• Mental Health Counselor in Muskegon, MI
• Providers in Muskegon, MI by specialty
• Mental Health Counselor in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.