BREN SHANTZ (NPI# 1003283169) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1003283169 |
| Entity Type | Individual |
| Full Name | BREN SHANTZ |
| Credential | LPC, LLP |
| Practice Address |
4890 11 Mile Rd Ne Rockford MI 49341-8477 |
| Mailing Address |
3201 Burton St Se Grand Rapids MI 49546-4301 |
| Practice Telephone | 6164391866 |
| Mailing Telephone | 6164391866 |
| Enumeration Date | 2015-08-25 |
| Last Update Date | 2019-01-03 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YP2500X |
Counselor Specialization: Professional |
6401014444 | MI | Behavioral Health & Social Service Providers |
| N | 103TC1900X |
Psychologist Specialization: Counseling |
6301016034 | MI | Behavioral Health & Social Service Providers |
| Street Address |
4890 11 MILE RD NE |
| City | ROCKFORD |
| State | MI |
| Zip Code | 49341-8477 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801451836 | Heather Nash | Social Worker | 65 S. Main Street, Lower Level, Rockford, MI 49341 | 2019-05-06 |
| 1366967069 | Caitlin Lebron | Case Manager/Care Coordinator | 8625 Wildcat Run Dr Ne, Rockford, MI 49341 | 2017-08-03 |
| 1366967077 | Elite Nurse Staffing, LLC | Nursing Care | 3836 Windwood Drive, Ne, Rockford, MI 49341 | 2017-08-03 |
| 1336678747 | Melissa Diane Maynard | Behavior Technician | 3361 36th St., Grand Rapids, MI 49341 | 2017-06-08 |
| 1376077453 | Spectrum Health Primary Care Partners | Internal Medicine | 8501 Meadowcreek Dr, Rockford, MI 49341 | 2017-04-17 |
| 1871025254 | Robin D Dine | Behavior Technician | 8636 Shaner Ave, Rockford, MI 49341 | 2017-04-03 |
| 1528503216 | Miles Skalnek | Pharmacist | 511 10 Mile Road, Rockford, MI 49341 | 2017-01-04 |
| 1366801664 | Lorri Ann Kelbel | Massage Therapist | 11591 Northland Drive Ne, Rockford, MI 49341 | 2016-02-15 |
| 1275872046 | Eugene Louis Bonofiglo | Dentist | 4655- 14 Mile Rd Ne, Rockford, MI 49341 | 2013-02-13 |
| 1740539246 | Erica Joyce Nichols | Chiropractor | 6769 Courtland Dr, Suite 100, Rockford, MI 49341 | 2012-08-30 |
| Find all providers in zip 49341 | ||||
| Taxonomy Code | 101YP2500X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Professional |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114536406 | Jennifer Amy Stone | Counselor | 4433 Hillrise Ct Ne, Rockford, MI 49341-9651 | 2020-07-23 |
| 1992346605 | Cara Kimble | Counselor | 308 W State St Ste 250, Rockford, IL 61101-1140 | 2019-10-03 |
| 1932753258 | Dimensions of Wellness and Transformation, Inc | Counselor | 3701 E State St Ste H, Rockford, IL 61108-1975 | 2019-07-25 |
| 1871094870 | Rachel Schultz | Counselor | 1639 N Alpine Rd Ste 403, Rockford, IL 61107-1440 | 2018-02-24 |
| 1669987806 | Jilian Santander Rakow | Counselor | 10525 Edgerton Ave Ne, Rockford, MI 49341-9120 | 2017-12-11 |
| 1184072126 | Carlton Martin | Counselor | 5896 Creekside Ln, Rockford, IL 61114-6466 | 2016-06-01 |
| 1003273830 | Darcy Krause | Counselor | 6556 Bella Vista Dr Ne, 26 N Main St, Rockford, MI 49341-7861 | 2016-01-25 |
| 1023489853 | Nicole Ping Ticknor | Counselor | 433 S. Phelps Ave., Suite 2, Rockford, IL 61108 | 2015-10-20 |
| 1710371406 | Rebecca Gielow | Counselor | 2518 Whitmire Dr, Rockford, IL 61109-6732 | 2015-03-20 |
| 1528450673 | Brenda Byrnewilson | Counselor | 2616 19th Ave, Rockford, IL 61108-5734 | 2015-02-26 |
| Find all providers in ROCKFORD | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.