Individual provider Active NPI

Brandi Jai-Tyler Marable, MSW

  • Clinical Social Worker
  • Detroit, MI
National Provider Identifier
1104473123
Registry record updated Aug 23, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
N906539 Issued in MI
Practice address
18244 W McNichols Rd
Detroit, MI 48219-4163
Phone
(313) 208-3407
Fax
(313) 209-4533
NPI assigned
Aug 23, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 23, 2019

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 N906539 MI Primary

Addresses

Primary practice location

18244 W McNichols Rd
Detroit, MI 48219-4163

Mailing address

2510 Longfellow St
Detroit, MI 48206-2076
Phone (313) 673-6636

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
N906539MIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Motor City Center for Hope LLC CurrentSince May 16, 2021 Accepting new patients
Motor City Center for Hope LLC Clinical CurrentSince May 16, 2021 Accepting new patients

Locations

18244 W McNichols Rd
Detroit, MI 48219
Phone (313) 208-3407

Organizations & group practices 2

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": "1566518400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566518400000",
    "number": "1104473123",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2510 LONGFELLOW ST",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482062076",
            "telephone_number": "313-673-6636"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18244 W MCNICHOLS RD",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482194163",
            "telephone_number": "313-208-3407",
            "fax_number": "313-209-4533"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARABLE",
        "first_name": "BRANDI",
        "middle_name": "JAI-TYLER",
        "name_prefix": "Mrs.",
        "credential": "MSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-08-23",
        "last_updated": "2019-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "N906539",
            "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 23, 2019; 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.