Individual provider Active NPI

Willis Byas, LLMSW

  • Clinical Social Worker
  • Berrien Springs, MI
National Provider Identifier
1013784578
Registry record updated Dec 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6851117522 Issued in MI
Practice address
8564 W Campus Circle Dr
Berrien Springs, MI 49103-9527
Phone
(917) 342-4626
NPI assigned
Dec 5, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 5, 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 6851117522 MI Primary

Addresses

Primary practice location

8564 W Campus Circle Dr
Berrien Springs, MI 49103-9527

Mailing address

8564 W Campus Circle Dr
Berrien Springs, MI 49103-9527
Phone (917) 342-4626

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
6851117522MIMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1701734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701734400000",
    "number": "1013784578",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8564 W CAMPUS CIRCLE DR",
            "city": "BERRIEN SPRINGS",
            "state": "MI",
            "postal_code": "491039527",
            "telephone_number": "917-342-4626"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8564 W CAMPUS CIRCLE DR",
            "city": "BERRIEN SPRINGS",
            "state": "MI",
            "postal_code": "491039527",
            "telephone_number": "917-342-4626"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BYAS",
        "first_name": "WILLIS",
        "credential": "LLMSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-12-05",
        "last_updated": "2023-12-05",
        "certification_date": "2023-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6851117522",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Berrien Springs, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 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.