Koaster Brim, MSW,LMSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

6801106071 Issued in MI

Practice address

2500 S Linden Rd
Flint, MI 48532-7074

Phone

(810) 655-3867

NPI assigned

Aug 17, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Reimagine Telehealth Counseling and Consulting Services

  • Clinical Social Worker
  • Flint, MI
  • NPI 1073254389
  NPD Authorized official

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

{
    "created_epoch": "1439769600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1648857600000",
    "number": "1083080857",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2500 S LINDEN RD",
            "address_2": "P.O.BOX 320115",
            "city": "FLINT",
            "state": "MI",
            "postal_code": "485329998",
            "telephone_number": "810-655-3867"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 S LINDEN RD",
            "city": "FLINT",
            "state": "MI",
            "postal_code": "485327074",
            "telephone_number": "810-655-3867"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRIM",
        "first_name": "KOASTER",
        "name_prefix": "Ms.",
        "credential": "MSW,LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-08-17",
        "last_updated": "2022-04-02",
        "certification_date": "2022-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801106071",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "13189",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3833C",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Yvonne Marie Bridgeford
• Jacoy Semaj Bridges
• Neveah Bridges
• Kirklynn Briggs
• Bright Future Pediatrics P L L C
• Toni Brinker
• Peggy Lynn Brisbane-Noblit, MA
• Bristol Chiropractic Centre, P.C.
• La'Nija Monay Broach
• Broadway Elite Home Care

• Clinical Social Worker in Flint, MI
• Providers in Flint, 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 Apr 2, 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.