Active NPI
Samantha Rae Breneman, LLP
- Psychologist
- Brighton, MI
National Provider Identifier
1063860955
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 6361005809
- Practice address
- 2200 Genoa Business Park Dr Ste 100
Brighton, MI 48114-5328 - Phone
- (517) 492-0517
- Fax
- (810) 215-1334
- NPI assigned
- Jun 1, 2016
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 6361005809 | MI | Primary |
Addresses
Primary practice location
2200 Genoa Business Park Dr Ste 100
Brighton, MI 48114-5328
Mailing address
2200 Genoa Business Park Dr Ste 100
Brighton, MI 48114-5328
Phone (517) 492-0517
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6301018378 | MI | MD | Clinical Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Downriver Mental Health Clinic PC | Mental Health | Past | Accepting new patients |
Interoperability endpoints
- lifestancehealth.samanthabreneman@150339.advancedmd-direct.com
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1464739200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1786492800000",
"number": "1063860955",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2200 GENOA BUSINESS PARK DR STE 100",
"city": "BRIGHTON",
"state": "MI",
"postal_code": "481145328",
"telephone_number": "517-492-0517",
"fax_number": "810-215-1334"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2200 GENOA BUSINESS PARK DR STE 100",
"city": "BRIGHTON",
"state": "MI",
"postal_code": "481145328",
"telephone_number": "517-492-0517",
"fax_number": "810-215-1334"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRENEMAN",
"first_name": "SAMANTHA",
"middle_name": "RAE",
"credential": "LLP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-06-01",
"last_updated": "2026-08-12",
"certification_date": "2026-08-12",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "MI",
"license": "6361005809",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Brighton, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.