NICHOLAS SCOTT BRENNFOERDER, LPC — NPI 1629473939 (Licensed & Credentialed Behavioral Health & Social Service Providers

CMS-1500 Box 24J / 33a • NPI

1629473939

Type 1 Individual Rendering/Ordering

HIPAA NUCC Taxonomy • CMS Code

101YP2500X (CMS E2)

Licensed & Credentialed Behavioral Health & Social Service Providers — Counselor

Box 32 Service Location & ZIP+4

17325 VAN WAGONER RD, SPRING LAKE, MI, 49456-9702

✓ 9-Digit EDI 837 ZIP+4 (49456-9702)

Practice Phone & Referral Fax

(616) 847-5145

Direct NPPES Verification Line

✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR: NPI 1629473939 (NICHOLAS SCOTT BRENNFOERDER, LPC) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).

CMS Medicare Order & Referring PECOS Eligibility

Medicare Part B

✓ Eligible

DMEPOS Ordering

✓ Eligible

Home Health (HHA)

Power Mobility

Hospice Referring

Official CMS NPPES Credential & Practice Profile

10-Digit NPI Number	`1629473939` (NPI-1 Individual Practitioner)
Provider / Legal Name	NICHOLAS SCOTT BRENNFOERDER, LPC
Plain-English Specialty	Licensed & Credentialed Behavioral Health & Social Service Providers — Counselor NUCC Code: `101YP2500X` (Counselor, Professional)
Certifying / Licensing Body	State Medical / Healthcare Licensing Board & National Specialty Board
Practice Location Address	17325 VAN WAGONER RD, SPRING LAKE, MI, 49456-9702
Practice Telephone / Fax	Tel: (616) 847-5145
Administrative Mailing Address	300 68TH ST SE, GRAND RAPIDS, MI, 49548-6927
Enumeration & Last Sync	Enumerated: 2014-10-29 \| CMS Record Updated: 2023-12-21

Clinic Location, Accessibility & Directions

📍 Practice Location & Patient Access

17325 VAN WAGONER RD, SPRING LAKE, MI, 49456-9702

🗺️ Open in Google Maps 🏥 More Providers in SPRING LAKE

🔒 Are you NICHOLAS SCOTT BRENNFOERDER, LPC? Get your Verified NPI Clinic Badge or request personal phone/address redaction →

Plain-English Taxonomy & CMS Crosswalk (101YP2500X)

What Does Taxonomy Code 101YP2500X Mean?

In the HIPAA National Uniform Claim Committee (NUCC) classification, code 101YP2500X translates to:
"Licensed & Credentialed Behavioral Health & Social Service Providers — Counselor"

CMS-1500 Medicare Specialty Crosswalk: CMS Code E2 (Licensed Professional Counselor)
Certifying / Accrediting Authority: State Medical / Healthcare Licensing Board & National Specialty Board
Clinical Scope: Consult a verified Counselor, Professional for specialized diagnostic evaluation, treatment planning, and continuity of care.

Specialty Clinical Procedures & Therapeutic Classes

Standard Scope of Care (NICHOLAS SCOTT BRENNFOERDER, LPC)

Typical CPT / Diagnostic Procedures:

Comprehensive Outpatient & Inpatient Clinical Evaluation (CPT 99202–99215)
Diagnostic Workup, Laboratory Ordering & Evidence-Based Care Coordination
Preventive Screening, Patient Counseling & Multidisciplinary Referral

Common Therapeutic Classes:

Evidence-Based Specialty Pharmacotherapy & Preventive Regimens (CMS Part D Standard)

All Registered NUCC Taxonomies & State Licenses

Taxonomy Code & Plain-English Description	State License & Primary Status
`101YP2500X` — Counselor, Professional Plain English: Licensed & Credentialed Behavioral Health & Social Service Providers — Counselor	State: IL \| License: `180011577` \| Primary: Secondary
`101YP2500X` — Counselor, Professional Plain English: Licensed & Credentialed Behavioral Health & Social Service Providers — Counselor	State: MI \| License: `6401017306` \| Primary: Yes (Primary)

Medical Billing, RCM & Hospital Credentialing Teams:

Batch-verify up to 25 NPIs free against CMS NPPES + Medicare PECOS + HHS OIG Exclusions with 1-click CSV export.

Launch Bulk NPI Checker → JSON API Docs

NICHOLAS SCOTT BRENNFOERDER, LPC (NPI #1629473939)