Individual provider Active NPI

Matthew Brown, LLMSW

  • Clinical Social Worker
  • Detroit, MI
National Provider Identifier
1053720706
Registry record updated Aug 7, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801094035 Issued in MI
Practice address
11457 Shoemaker St
Detroit, MI 48213-3418
Phone
(313) 331-3435
NPI assigned
Aug 7, 2014
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 7, 2014

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 6801094035 MI Primary

Addresses

Primary practice location

11457 Shoemaker St
Detroit, MI 48213-3418

Mailing address

8235 Prestwick LN
Washington, MI 48095-2858
Phone (248) 877-6524

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

State licenses

LicenseStateTypeSpecialty
6801094035MIMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1407369600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1407369600000",
    "number": "1053720706",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8235 PRESTWICK LN",
            "city": "WASHINGTON",
            "state": "MI",
            "postal_code": "480952858",
            "telephone_number": "248-877-6524"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11457 SHOEMAKER ST",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482133418",
            "telephone_number": "313-331-3435"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN",
        "first_name": "MATTHEW",
        "credential": "LLMSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-08-07",
        "last_updated": "2014-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801094035",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2014; 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.