Individual provider Active NPI

Olivia Grace Brower, LMSW

  • Clinical Social Worker
  • Ann Arbor, MI
National Provider Identifier
1154970333
Registry record updated Nov 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801105666 Issued in MI
Practice address
1785 W Stadium Blvd
Ann Arbor, MI 48103-5285
Phone
(734) 913-1093
NPI assigned
Sep 10, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 29, 2021

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 6801105666 MI Primary

Addresses

Primary practice location

1785 W Stadium Blvd
Ann Arbor, MI 48103-5285

Mailing address

4215 Strathmore LN
Canton, MI 48188-7217
Phone (616) 862-7736

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
I20211228000116 MI Practitioner - Clinical Social Worker 2365833423 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Second Story Counseling II LLCGroup PAC ID 6204292063, 18 clinicians

Practice addresses (Care Compare)

3424 Chicago Dr
Suite 205
Hudsonville, MI 49426-1411
Phone (616) 426-9034

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6801105666MIMDClinical Social Worker

Organizations & group practices 1

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": "1568073600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638144000000",
    "number": "1154970333",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4215 STRATHMORE LN",
            "city": "CANTON",
            "state": "MI",
            "postal_code": "481887217",
            "telephone_number": "616-862-7736"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1785 W STADIUM BLVD",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481035285",
            "telephone_number": "734-913-1093"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWER",
        "first_name": "OLIVIA",
        "middle_name": "GRACE",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-09-10",
        "last_updated": "2021-11-29",
        "certification_date": "2021-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801105666",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ann Arbor, MI

Sources for this page

Verify at the official NPI Registry.