Matthew D Bradley, LLMSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

6851117339 Issued in MI

Practice address

110 Sanborn Ave Ste B
Big Rapids, MI 49307-1769

Phone

(231) 527-5415

NPI assigned

Sep 11, 2023

Sex

Male

Sole proprietor

No

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Sep 11, 2023.

{
    "created_epoch": "1694390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694390400000",
    "number": "1013794585",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "311 N STATE ST",
            "city": "BIG RAPIDS",
            "state": "MI",
            "postal_code": "493071446",
            "telephone_number": "231-527-5415"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 SANBORN AVE STE B",
            "city": "BIG RAPIDS",
            "state": "MI",
            "postal_code": "493071769",
            "telephone_number": "231-527-5415"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRADLEY",
        "first_name": "MATTHEW",
        "middle_name": "D",
        "credential": "LLMSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-09-11",
        "last_updated": "2023-09-11",
        "certification_date": "2023-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6851117339",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christy Bourdlais, NP
• Amanda Grace Bouvrette
• Andrea Bouwknegt
• Dawn Boven, MA, CCC-SLP
• Brooklynn Boyd
• Kristi Kae Brege, PHARMD
• Kara Nicole Bremer, ATC
• Bright Smiles
• Rebecca Lynn Brinks, OTRL
• Emily Renee Bromley Castaneda, MD

• All providers in Big Rapids, MI
• Clinical Social Worker in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 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.