Provider Demographics
NPI:1427242320
Name:BREMER, NICHOL LYNN (LMSW)
Entity type:Individual
Prefix:MRS
First Name:NICHOL
Middle Name:LYNN
Last Name:BREMER
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:NICHOL
Other - Middle Name:LYNN
Other - Last Name:BECKER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:375 APPLE TREE DR
Mailing Address - Street 2:IONIA COUNTY COMMUNITY MENTAL HEALTH
Mailing Address - City:IONIA
Mailing Address - State:MI
Mailing Address - Zip Code:48846-7506
Mailing Address - Country:US
Mailing Address - Phone:616-527-1790
Mailing Address - Fax:616-527-0538
Practice Address - Street 1:375 APPLE TREE DR
Practice Address - Street 2:IONIA COUNTY COMMUNITY MENTAL HEALTH
Practice Address - City:IONIA
Practice Address - State:MI
Practice Address - Zip Code:48846-7506
Practice Address - Country:US
Practice Address - Phone:616-527-1790
Practice Address - Fax:616-527-0538
Is Sole Proprietor?:No
Enumeration Date:2007-09-04
Last Update Date:2012-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010889691041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical