Individual provider Active NPI

Kathryn Joanne Brown, LMSW

  • Addiction (Substance Use Disorder) Counselor
  • South Lyon, MI
National Provider Identifier
1104286046
Registry record updated Jun 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
6801096946 Issued in MI
Practice address
127 N Lafayette St
South Lyon, MI 48178-1210
Phone
(248) 573-7417
NPI assigned
Mar 4, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 6801096946 MI Primary
Mental Health Counselor 101YM0800X

Addresses

Primary practice location

127 N Lafayette St
South Lyon, MI 48178-1210

Mailing address

1370 N Oakland Blvd Ste 105
Waterford, MI 48327-1572
Phone (248) 396-7390

Other practice location 1

1370 N Oakland Blvd Ste 105
Waterford, MI 48327-1572
Phone (248) 666-8870

Other identifiers 1

IdentifierTypeStateIssuer
6801096946OtherMISTATE OF MI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170131002733 MI Practitioner - Clinical Social Worker 8426330291 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Antoinette Peterson, LLC 9 clinicians

Practice addresses (Care Compare)

147 N Milford Rd
Suite 201
Highland, MI 48357-4500
Phone (248) 563-0587

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Lyon Counseling Center CurrentSince Jun 30, 2025 Accepting new patients
Antoinette Peterson,LLC CurrentSince Aug 1, 2020 Accepting new patients
Mental Health Specialty Group PA Mental Health CurrentSince Jul 1, 2025 Accepting new patients
Mattioli Mental Health Clinic PLLC PastSince May 25, 2025 Accepting new patients

Locations

10524 Grand River Rd
Ste 101
Brighton, MI 48116
Phone (248) 573-7417

400 Renaissance Ctr
Detroit, MI 48243
Phone (248) 599-1582

147 N Milford Rd
Ste 201
Highland, MI 48357
Phone (248) 563-0587

127 N Lafayette St
South Lyon, MI 48178
Phone (248) 573-7417

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1457049600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751241600000",
    "number": "1104286046",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1370 N OAKLAND BLVD STE 105",
            "city": "WATERFORD",
            "state": "MI",
            "postal_code": "483271572",
            "telephone_number": "248-396-7390"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "127 N LAFAYETTE ST",
            "city": "SOUTH LYON",
            "state": "MI",
            "postal_code": "481781210",
            "telephone_number": "248-573-7417"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1370 N Oakland Blvd Ste 105",
            "address_purpose": "LOCATION",
            "city": "Waterford",
            "state": "MI",
            "postal_code": "483271572",
            "country_code": "US",
            "telephone_number": "248-666-8870",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BROWN",
        "first_name": "KATHRYN",
        "middle_name": "JOANNE",
        "name_prefix": "Mrs.",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-03-04",
        "last_updated": "2025-06-30",
        "certification_date": "2025-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "MI",
            "license": "6801096946",
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE OF MI",
            "identifier": "6801096946",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in South Lyon, MI

Sources for this page

Verify at the official NPI Registry.