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NICHOLAS SCOTT BRENNFOERDER LPC
NPI 1629473939
Counselor - Professional in Spring Lake, MI

Active since October 29, 2014PECOS EnrolledAccepts Medicare Assignment
17325 VAN WAGONER RD, SPRING LAKE, MI 49456(616) 847-5145 Get Directions Write a Review

NPPES record last updated: December 21, 2023. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Aug 21, 2018, Apr 23, 2018 (2 updates tracked since 2018).

About Nicholas Scott Brennfoerder Lpc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

NICHOLAS SCOTT BRENNFOERDER LPC (NPI 1629473939) is an individual professional provider in Spring Lake, Michigan, licensed in Michigan (6401017306) and active in the NPI registry since October 2014. He is enrolled in Medicare PECOS and is a graduate of Other (2012).

NPPES Registry Identity

NPI1629473939
Entity TypeIndividualMale
Primary Taxonomy101YP2500X
Provider Legal NameNICHOLAS SCOTT BRENNFOERDERCredential: LPC
Location Address17325 VAN WAGONER RDSpring Lake, MI 49456-9702
Mailing Address300 68th St SeGrand Rapids, MI 49548-6927 · (616) 455-5000
Phone(616) 847-5145
Sole ProprietorNo
Medical School CMSOtherGraduated 2012
Enumeration DateOctober 29, 2014
Last NPPES UpdateDecember 21, 20232 updates tracked since enumeration
NPPES CertifiedDecember 21, 2023
✔ NPI 1629473939 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · ProfessionalBehavioral Health & Social Service Providers
Taxonomy Code101YP2500X
Licenses✔ Licensed in MI · 6401017306✔ Licensed in IL · 180011577
17325 VAN WAGONER RD, Spring Lake, MI 49456
Open in Google Maps ↗

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter from Meridian, Ambetter Health and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Nicholas Scott Brennfoerder Lpc is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID8426409350
PECOS Enrollment IDI20240104003848
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Nicholas Brennfoerder reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Pine Rest Christian Mental Health Services
34 mi
Professional
300 68TH ST SE
Grand Rapids, MI 49548
  • Reassigned Medicare billing, Michigan enrollment
  • 135 clinicians in this Medicare group
NPI 1386015683 (616) 281-6372

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Other Providers at the Same Location NPPES 17

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MISS CAITLYN N JETTER PA-C
Physician Assistant
17325 VAN WAGONER RD
SPRING LAKE, MI 49456
Ottawa County (616) 847-5145
LINDA ANN JOHNSON LCSW, LMSW
Social Worker (Clinical)
17325 VAN WAGONER RD
SPRING LAKE, MI 49456
Ottawa County (616) 847-5145
AMANDA LUDLOW LPC
Counselor (Professional)
17325 VAN WAGONER RD
SPRING LAKE, MI 49456
Ottawa County (616) 847-5145
TONYA J DUTTON LMSW
Social Worker (Clinical)
17325 VAN WAGONER RD
SPRING LAKE, MI 49456
Ottawa County (616) 847-5145
LORI LYNN-BERG MCDIARMID LLP
Psychologist
17325 VAN WAGONER RD
SPRING LAKE, MI 49456
Ottawa County (616) 847-5145
KATHERINE ANN JAWOR D.O.
Psychiatry & Neurology (Psychiatry)
17325 VAN WAGONER RD
SPRING LAKE, MI 49456
Ottawa County (616) 364-1500
SARA NICOLE PATZER MSW
Social Worker (Clinical)
17325 VAN WAGONER RD
SPRING LAKE, MI 49456
Ottawa County (616) 847-5145
PINE REST CHRISTIAN MENTAL HEALTH SERVICES
Psychiatric Hospital
17325 VAN WAGONER RD
SPRING LAKE, MI 49456
Ottawa County (616) 847-5145

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Nicholas Brennfoerder's NPI number?

The NPI number for Nicholas Brennfoerder is 1629473939. It was assigned to this individual provider in the NPPES registry on October 29, 2014.

Where is Nicholas Brennfoerder located?

Nicholas Brennfoerder practices at 17325 Van Wagoner Rd, Spring Lake, MI 49456. The listed phone number is (616) 847-5145.

What is Nicholas Brennfoerder's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Professional, with taxonomy code 101YP2500X.

Is Nicholas Brennfoerder enrolled in Medicare?

Yes. Nicholas Brennfoerder is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organization bills Medicare for Nicholas Brennfoerder's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Nicholas Brennfoerder reassigns Medicare benefits to Pine Rest Christian Mental Health Services (Grand Rapids, MI). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Nicholas Brennfoerder's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Nicholas Brennfoerder accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Meridian, Blue Care Network of Michigan and Blue Cross Blue Shield of Michigan Mutual Insurance Company and 3 other insurers list Nicholas Brennfoerder as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Nicholas Brennfoerder was last updated on December 21, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.