Blue Water Mental Health Clinic

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

BLUE WATER MENTAL HEALTH CLINIC

Practice address

7557 Brockway Rd
Brockway, MI 48097-3410

Phone

(810) 985-5125

Fax

(810) 985-5127

NPI assigned

Feb 2, 2007

Last updated

Sep 11, 2026By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Amy Elizabeth FabickNPI 1245263474

Title

Executive Director

Phone

(810) 689-6565

Specialties & licenses 6

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Blue Water Mental Health Clinic

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Fort Gratiot, MI
  • NPI 1457305419

  O20060531000214

  Same enrollment

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Amy Fabick, MSW

  • Clinical Social Worker
  • Fort Gratiot, MI
  • NPI 1245263474
  Authorized official Same address or phone
• Megan Marie Bennett-O'Brien

  • Social Worker
  • Port Huron, MI
  • NPI 1972513216
  NPD
• Kimberly Rose Peltz, LMSW

  • Clinical Social Worker
  • Fort Gratiot, MI
  • NPI 1497986616
  NPD (past)

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

{
    "created_epoch": "1170374400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1789084800000",
    "number": "1467590406",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1501 KRAFFT RD",
            "city": "FORT GRATIOT",
            "state": "MI",
            "postal_code": "480593565",
            "telephone_number": "810-985-5125",
            "fax_number": "810-985-5127"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7557 BROCKWAY RD",
            "city": "BROCKWAY",
            "state": "MI",
            "postal_code": "480973410",
            "telephone_number": "810-985-5125",
            "fax_number": "810-985-5127"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLUE WATER MENTAL HEALTH CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-02",
        "last_updated": "2026-09-11",
        "certification_date": "2026-09-11",
        "status": "A",
        "authorized_official_last_name": "FABICK",
        "authorized_official_first_name": "AMY",
        "authorized_official_middle_name": "ELIZABETH",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "810-689-6565"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Abundant Health Pharmacy (Medicine Chest Pharmacy)
• Michell Apley
• Marc Christopher Brancaccio, PHARMD.
• Laura Louise Brosius
• Madisyn Burks
• Kathleen Hurst Chmielewski, DDS
• Dreama K Closser

• Mental Health Clinic/Center (Including Community Mental Health Center) in Brockway, MI
• Providers in Brockway, MI by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.