Individual provider Active NPI

Ellen Louise Codere, LMSW

  • Clinical Social Worker
  • Brighton, MI
National Provider Identifier
1003109885
Registry record updated Oct 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801083256 Issued in MI
Practice address
2200 Genoa Business Park Dr Ste 100
Brighton, MI 48114-5328
Phone
(517) 882-3732
Fax
(517) 882-3633
NPI assigned
May 26, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 3, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 6801083256 MI Primary

Addresses

Primary practice location

2200 Genoa Business Park Dr Ste 100
Brighton, MI 48114-5328

Mailing address

2200 Genoa Business Park Dr Ste 100
Brighton, MI 48114-5328
Phone (517) 882-3732

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Interoperability endpoints

  • Direct secure messaging: lifestancehealth.ellencodere@150339.advancedmd-direct.com

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1306368000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696291200000",
    "number": "1003109885",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2200 GENOA BUSINESS PARK DR STE 100",
            "city": "BRIGHTON",
            "state": "MI",
            "postal_code": "481145328",
            "telephone_number": "517-882-3732",
            "fax_number": "517-882-3633"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2200 GENOA BUSINESS PARK DR STE 100",
            "city": "BRIGHTON",
            "state": "MI",
            "postal_code": "481145328",
            "telephone_number": "517-882-3732",
            "fax_number": "517-882-3633"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CODERE",
        "first_name": "ELLEN",
        "middle_name": "LOUISE",
        "name_prefix": "Ms.",
        "credential": "LMSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-05-26",
        "last_updated": "2023-10-03",
        "certification_date": "2023-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801083256",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brighton, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.