Individual provider Active NPI

Breonna Mosley, MSW

  • Case Manager/Care Coordinator
  • Saginaw, MI
National Provider Identifier
1164088639
Registry record updated Jan 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Manager/Care CoordinatorTaxonomy code 171M00000X
Practice address
3400 S Washington Rd
Saginaw, MI 48601-4958
Phone
(989) 755-1072
NPI assigned
May 10, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 19, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 6851115933 MI
Behavior Technician 106S00000X
Case Manager/Care Coordinator 171M00000X Primary

Addresses

Primary practice location

3400 S Washington Rd
Saginaw, MI 48601-4958

Mailing address

3400 S Washington Rd
Saginaw, MI 48601-4958
Phone (989) 755-1072

Other practice location 1

2521 N Elms Rd
Flushing, MI 48433-9423
Phone (810) 487-5521

Other practice location 2

3253 Congress Ave
Saginaw, MI 48602-3106
Phone (989) 475-4171

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL www.holycrossservices.org

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
6851115933MIMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1557446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674086400000",
    "number": "1164088639",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3400 S WASHINGTON RD",
            "city": "SAGINAW",
            "state": "MI",
            "postal_code": "486014958",
            "telephone_number": "989-755-1072"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3400 S WASHINGTON RD",
            "city": "SAGINAW",
            "state": "MI",
            "postal_code": "486014958",
            "telephone_number": "989-755-1072"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2521 N Elms Rd",
            "address_purpose": "LOCATION",
            "city": "Flushing",
            "state": "MI",
            "postal_code": "484339423",
            "country_code": "US",
            "telephone_number": "810-487-5521",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3253 Congress Ave",
            "address_purpose": "LOCATION",
            "city": "Saginaw",
            "state": "MI",
            "postal_code": "486023106",
            "country_code": "US",
            "telephone_number": "989-475-4171",
            "fax_number": "989-393-6021",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOSLEY",
        "first_name": "BREONNA",
        "credential": "MSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-05-10",
        "last_updated": "2023-01-19",
        "certification_date": "2023-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6851115933",
            "primary": false
        },
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "www.holycrossservices.org",
            "affiliation": "N",
            "address_1": "3400 S Washington Rd",
            "city": "Saginaw",
            "state": "MI",
            "country_code": "US",
            "postal_code": "486014958",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Saginaw, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2023; 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.