COOPER BRUBACHER (LLMSW) – Addiction (Substance Use Disorder) Counselor, NPI 1669976189

COOPER BRUBACHER (LLMSW) is a healthcare provider. based in Petoskey, Michigan. specializing in CLINICAL SOCIAL WORKER. They hold the professional credentials LLMSW. They hold a License No. 6801100374 (MI). The NPI Number for COOPER BRUBACHER (LLMSW) is 1669976189

Main info

Male
10 Years Of Experience
Accepts Medicare Assignment
Name
COOPER BRUBACHER (LLMSW)
NPI
1669976189
Phone
Not provided
Address
704 EMMET ST
Enumeration Date
20 March 2018
Last Update Date
20 March 2018

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2319416550
Graduation Year
2016 (10 years ago)
PAC ID
0648654046
Group Practice PAC ID
2466600101
Professional Enrollment ID
I20220902002261
Address ID
MI496843247TR512XXSTXX400
Telehealth
Yes
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience30
Completeness75
Years active:8State licenses:1Digital endpointsOther names

4,821 CLINICAL SOCIAL WORKER in MI

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Provider Addresses for COOPER BRUBACHER (LLMSW)

  • 704, Emmet Street, Petoskey, Emmet County, Michigan, 49770, United States

    PETOSKEY, MI 497702910

    Phone:

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2022-09-02

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20220902002261IClinical Social WorkerMITBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 49770)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 2466600101View full group profile
NameSpecialtyState
Mental Health CounselorMI
Clinical PsychologistMI
Clinical Social WorkerMI
Clinical Social WorkerMI
-MI
Mental Health CounselorMI
Clinical PsychologistMI
Clinical PsychologistMI
Mental Health CounselorMI
-MI

Reviews

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Frequently asked questions

What federal number belongs to COOPER BRUBACHER (LLMSW)?
The federal identifier for COOPER BRUBACHER (LLMSW) is NPI 1669976189.
Is COOPER BRUBACHER (LLMSW) active in the national directory?
COOPER BRUBACHER (LLMSW)'s public NPI profile is in an active state.
What kind of provider is COOPER BRUBACHER (LLMSW)?
The page reflects Addiction (Substance Use Disorder) Counselor for COOPER BRUBACHER (LLMSW). Clinical services aligned with this taxonomy classification.
Where is COOPER BRUBACHER (LLMSW)'s primary listing?
We display Petoskey, Michigan because that is what the record indicates for COOPER BRUBACHER (LLMSW).
Is COOPER BRUBACHER (LLMSW) a real provider?
This page reflects official NPPES data for NPI 1669976189. Always confirm identity and privileges with the practice and licensing boards.

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