Provider Demographics
NPI:1679218879
Name:MUIR, BRIAN DAVID (LLMSW, MDIV)
Entity type:Individual
Prefix:MR
First Name:BRIAN
Middle Name:DAVID
Last Name:MUIR
Suffix:
Gender:M
Credentials:LLMSW, MDIV
Other - Prefix:
Other - First Name:BRIAN
Other - Middle Name:DAVID
Other - Last Name:MOORE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:560 JACOB WAY APT 202
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:MI
Mailing Address - Zip Code:48307-2287
Mailing Address - Country:US
Mailing Address - Phone:734-302-3001
Mailing Address - Fax:
Practice Address - Street 1:103 E LIBERTY ST STE 202
Practice Address - Street 2:
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48104-2136
Practice Address - Country:US
Practice Address - Phone:734-302-3001
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-02
Last Update Date:2025-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68511185211041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical