Shelley M Brandow, LPC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

6401006918 Issued in MI

Practice address

1029 N 3Rd St
Suite B
Marquette, MI 49855-3509

Phone

(906) 226-7410

NPI assigned

Jun 23, 2010

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Shelley MB Wiegand Former name

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

Specialty

Mental Health Counselor

Education

Other, 1997

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Suunta Integrative HealthGroup PAC ID 8022340900, 7 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Suunta Integrative Health

  • Clinical Social Worker
  • Marquette, MI
  • NPI 1720646508
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1277251200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1277251200000",
    "number": "1609187855",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1029 N 3RD ST",
            "address_2": "SUITE B",
            "city": "MARQUETTE",
            "state": "MI",
            "postal_code": "498553509",
            "telephone_number": "906-226-7410"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1029 N 3RD ST",
            "address_2": "SUITE B",
            "city": "MARQUETTE",
            "state": "MI",
            "postal_code": "498553509",
            "telephone_number": "906-226-7410"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRANDOW",
        "first_name": "SHELLEY",
        "middle_name": "M",
        "name_prefix": "Miss",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-06-23",
        "last_updated": "2010-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MI",
            "license": "6401006918",
            "primary": true
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MI",
            "license": "6802080124",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHELLEY",
            "last_name": "WIEGAND",
            "middle_name": "MB",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Donna J Boyd, M.D.
• Jennifer J Boyerdewitt
• Rubina Christine Boyrazian, OTD, OTR/L
• Valerie Bradley-Holliday, PH.D., L.M.S.W.
• John Bradtke
• Melissa Brandt
• Katrina M Brang, MD
• Caitlyn Lee Bratton
• Gabrielle Bray
• John W Bray, LLMSW

• Mental Health Counselor in Marquette, MI
• Providers in Marquette, 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 Jun 23, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.