BRENNFOERDER CLINICAL SERVICES LLC — NPI 1992622690 (Licensed & Credentialed Behavioral Health & Social Service Providers

CMS-1500 Box 24J / 33a • NPI

1992622690

Type 2 Organization (Box 32a/33a)

HIPAA NUCC Taxonomy • CMS Code

101YM0800X (CMS E2)

Licensed & Credentialed Behavioral Health & Social Service Providers — Counselor

Box 32 Service Location & ZIP+4

845 PARK AVE, GRAND HAVEN, MI, 49417-2112

✓ 9-Digit EDI 837 ZIP+4 (49417-2112)

Practice Phone & Referral Fax

(303) 898-9367

Direct NPPES Verification Line

✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR: NPI 1992622690 (BRENNFOERDER CLINICAL SERVICES LLC) 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

Institutional Type-2 NPI facilities enroll via CMS-855A institutional provider agreements rather than individual Order & Referring PECOS.

Official CMS NPPES Credential & Practice Profile

10-Digit NPI Number	`1992622690` (NPI-2 Organization / Facility)
Provider / Legal Name	BRENNFOERDER CLINICAL SERVICES LLC
Plain-English Specialty	Licensed & Credentialed Behavioral Health & Social Service Providers — Counselor NUCC Code: `101YM0800X` (Counselor, Mental Health)
Certifying / Licensing Body	State Medical / Healthcare Licensing Board & National Specialty Board
Practice Location Address	845 PARK AVE, GRAND HAVEN, MI, 49417-2112
Practice Telephone / Fax	Tel: (303) 898-9367
Administrative Mailing Address	16259 PINE HOLLOW AVE, SPRING LAKE, MI, 49456-2254
Enumeration & Last Sync	Enumerated: 2026-07-02 \| CMS Record Updated: 2026-10-05
Authorized Official	KRISTA BRENNFOERDER (Owner, Therapist)

Clinic Location, Accessibility & Directions

📍 Practice Location & Patient Access

845 PARK AVE, GRAND HAVEN, MI, 49417-2112

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Plain-English Taxonomy & CMS Crosswalk (101YM0800X)

What Does Taxonomy Code 101YM0800X Mean?

In the HIPAA National Uniform Claim Committee (NUCC) classification, code 101YM0800X translates to:
"Licensed & Credentialed Behavioral Health & Social Service Providers — Counselor"

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

Specialty Clinical Procedures & Therapeutic Classes

Standard Scope of Care (BRENNFOERDER CLINICAL SERVICES LLC)

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
`101YM0800X` — Counselor, Mental Health Plain English: Licensed & Credentialed Behavioral Health & Social Service Providers — Counselor	State: N/A \| License: `Verified` \| Primary: Yes (Primary)

Medical Billing, RCM & Hospital Credentialing Teams:

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BRENNFOERDER CLINICAL SERVICES LLC (NPI #1992622690)