Jenna Bradfield, LLMSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

6851115522 Issued in MI

Practice address

3785 Veterans Dr
Traverse City, MI 49684-4516

Phone

(231) 946-8975

NPI assigned

Sep 13, 2022

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Child & Family Services of Northwestern Michigan, Inc.

  • Voluntary or Charitable Agency
  • Traverse City, MI
  • NPI 1821121468
  NPD (past)

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

{
    "created_epoch": "1663027200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663027200000",
    "number": "1033831409",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2400 MONTMORENCY LN",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496869704"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3785 VETERANS DR",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496844516",
            "telephone_number": "231-946-8975"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRADFIELD",
        "first_name": "JENNA",
        "credential": "LLMSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-09-13",
        "last_updated": "2022-09-13",
        "certification_date": "2022-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6851115522",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LARA",
            "identifier": "6851115522",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tori Lynn Boynton
• Alexis Bozek
• BPDC, PC
• Tabetha Bradburn, BEHAVIOR TECHNICIAN
• Kaylee Ann Bradeen, OTR/L
• Jessica Jackline Bradley, PHARM.D.
• Tanner William Bradley
• Terence Lee Bradley, PHD
• Robert Bradshaw
• Ashley Rebecca Bradt, D.O.

• Clinical Social Worker in Traverse City, MI
• Providers in Traverse City, MI by specialty
• Clinical Social Worker in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2022; 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.