Individual provider Active NPI

Kathleen Michelle Fouche Brazzle, M.D.

  • Psychiatry Physician
  • Pontiac, MI
National Provider Identifier
1629057906
Registry record updated Jan 27, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
4301052026 Issued in MI
Practice address
461 W Huron St Ste 107
Pontiac, MI 48341-1601
Phone
(248) 724-7600
Fax
(248) 724-6800
NPI assigned
Jan 13, 2006
Last updated
Jan 27, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 27, 2026

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 049875 GA
Child & Adolescent Psychiatry Physician 2084P0804X 049875 GA
Child & Adolescent Psychiatry Physician 2084P0804X 4301052026 MI
Psychiatry Physician 2084P0800X 4301052026 MI Primary

Addresses

Primary practice location

461 W Huron St Ste 107
Pontiac, MI 48341-1601

Mailing address

PO Box 430150
Pontiac, MI 48343-0150
Phone (248) 724-7600

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address kathleen.fouchebrazzle.p1@direct.oihn.nextgenshare.com

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: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050526000511 MI Practitioner - Psychiatry 7810939113 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Wayne State University School of Medicine, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Jewish Family ServiceGroup PAC ID 8729071170, 13 clinicians
Psygenics IncGroup PAC ID 9436465820, 8 clinicians

Practice addresses (Care Compare)

25900 Greenfield Rd
Suite 405
Oak Park, MI 48237-1267
Phone (248) 592-2300

6555 W Maple Rd
West Bloomfield, MI 48322-4926
Phone (248) 592-2300

7800 W Outer Dr
Suite 300
Detroit, MI 48235-3458
Phone (313) 340-4442

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
049875GAMDPsychiatry Physician
4301052026MIMDChild & Adolescent Psychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Havenwyck Hospital Inc Psychiatry CurrentSince Jul 10, 2017 Accepting new patients
Havenwyck Hospital Inc CurrentSince Jul 10, 2017 Accepting new patients
Psygenics Inc Psychiatry CurrentSince Apr 30, 2023 Accepting new patients
Recovery Physicians Network of Michigan Psychiatry CurrentSince Aug 1, 2021 Accepting new patients

Locations

1500 University Dr
Ste 173
Auburn Hills, MI 48326
Phone (248) 373-9200

1525 University Dr
Auburn Hills, MI 48326
Phone (248) 371-2200

7800 W Outer Dr
Ste 300
Detroit, MI 48235
Phone (313) 283-5135

27085 Gratiot Ave
Ste 101
Roseville, MI 48066
Phone (586) 204-5560

101 W Townsend Rd
Saint Johns, MI 48879
Phone (989) 403-6022

1660 Fort St
Trenton, MI 48183
Phone (734) 304-4159

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1137110400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1769472000000",
    "number": "1629057906",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 430150",
            "city": "PONTIAC",
            "state": "MI",
            "postal_code": "483430150",
            "telephone_number": "248-724-7600",
            "fax_number": "248-724-6800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "461 W HURON ST STE 107",
            "city": "PONTIAC",
            "state": "MI",
            "postal_code": "483411601",
            "telephone_number": "248-724-7600",
            "fax_number": "248-724-6800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOUCHE BRAZZLE",
        "first_name": "KATHLEEN",
        "middle_name": "MICHELLE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-13",
        "last_updated": "2026-01-27",
        "certification_date": "2026-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "GA",
            "license": "049875",
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "GA",
            "license": "049875",
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "MI",
            "license": "4301052026",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MI",
            "license": "4301052026",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kathleen.fouchebrazzle.p1@direct.oihn.nextgenshare.com",
            "affiliation": "N",
            "address_1": "461 W Huron St Ste 107",
            "city": "Pontiac",
            "state": "MI",
            "country_code": "US",
            "postal_code": "483411601",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Pontiac, MI

Sources for this page

Verify at the official NPI Registry.