Bradley C. Breneman, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

149013214 Issued in IL

Practice address

901 N 1St St
Suite 225
Springfield, IL 62702-3759

Phone

(217) 788-4065

Fax

(217) 788-4147

NPI assigned

Apr 29, 2010

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: bradleybreneman@sfc.allscriptsdirect.net

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.

• Springfield Clinic LLP

  • Multi-Specialty Clinic/Center
  • Springfield, IL
  • NPI 1215974415
  NPD
• Mental Health Centers of Central Illinois

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Springfield, IL
  • NPI 1225008113
  NPD (past)
• Mental Health Centers of Central Illinois

  • Clinical Social Worker
  • Springfield, IL
  • NPI 1750614798
  NPD (past)

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

{
    "created_epoch": "1272499200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1458259200000",
    "number": "1073830063",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "710 N 8TH ST",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627026324",
            "telephone_number": "217-525-1064",
            "fax_number": "217-525-1651"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 N 1ST ST",
            "address_2": "SUITE 225",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627023759",
            "telephone_number": "217-788-4065",
            "fax_number": "217-788-4147"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRENEMAN",
        "first_name": "BRADLEY",
        "middle_name": "C.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-04-29",
        "last_updated": "2016-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149013214",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brandy Kelley Counseling, PLLC
• Amy Michelle Branham, FNP-BC
• Kenneth Dale Brann Jr.
• Laurent Brard, MD, PHD
• Break Free Physical Therapy PLLC
• Careyana M Brenham, M.D.
• Rebecca Ann Brenneisen, NP
• Randall James Brenneman, MD
• Breana Bressan
• Mary E. Bretscher, M.D.

• Clinical Social Worker in Springfield, IL
• Providers in Springfield, IL by specialty
• Clinical Social Worker in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2016; 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.