Individual provider Active NPI

Bonnie Ayer Breidenbach, MALLP LPC

  • Counselor
  • Ann Arbor, MI
National Provider Identifier
1275558264
Registry record updated Jan 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
License
6401005658 Issued in MI
Practice address
164 Kingsbrook Ave
Ann Arbor, MI 48103-6603
Phone
(586) 944-8741
NPI assigned
Jul 12, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 24, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X 6401005658 MI Primary

Addresses

Primary practice location

164 Kingsbrook Ave
Ann Arbor, MI 48103-6603

Mailing address

164 Kingsbrook Ave
Ann Arbor, MI 48103-6603
Phone (586) 944-8741

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250410001028 MI Practitioner - Mental Health Counselor 8729237094 Practice locations: Ann Arbor, MI

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Ann Arbor, MI 48103
Phone (586) 944-8741

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6401005658MIMDCounselor

Practice roles

OrganizationSpecialtyStatusNew patients
Macrobiotic Ed Counseling & Psycho CurrentSince Oct 15, 2023 Accepting new patients

Locations

31936 Harper Ave
Saint Clair Shores, MI 48082

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": "1152662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737676800000",
    "number": "1275558264",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "164 KINGSBROOK AVE",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481036603",
            "telephone_number": "586-944-8741"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "164 KINGSBROOK AVE",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481036603",
            "telephone_number": "586-944-8741"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BREIDENBACH",
        "first_name": "BONNIE",
        "middle_name": "AYER",
        "name_prefix": "Ms.",
        "credential": "MALLP LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-12",
        "last_updated": "2025-01-24",
        "certification_date": "2025-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "MI",
            "license": "6401005658",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ann Arbor, MI

Sources for this page

Verify at the official NPI Registry.