Individual provider Active NPI

Laura L Brodt, M.S.W.

  • Clinical Social Worker
  • Coldwater, MI
National Provider Identifier
1174830467
Registry record updated Sep 8, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801070618 Issued in MI
Practice address
200 Orleans Blvd
Coldwater, MI 49036-1767
Phone
(517) 278-2129
Fax
(517) 279-8172
NPI assigned
Sep 8, 2010
Last updated
Sep 8, 2010By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 8, 2010

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 6801070618 MI Primary

Addresses

Primary practice location

200 Orleans Blvd
Coldwater, MI 49036-1767

Mailing address

200 Orleans Blvd
Coldwater, MI 49036-1767
Phone (517) 278-2129

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
I20110315000390 MI Practitioner - Clinical Social Worker 1355523176 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Branch County Community Mental Health AuthorityGroup PAC ID 4789612714, 12 clinicians

Practice addresses (Care Compare)

200 Vista Dr
Coldwater, MI 49036-1776
Phone (517) 278-2129

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6801070618MIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Branch County Community Mental Health Authority CurrentSince Aug 31, 2010 Accepting new patients

Locations

200 Orleans Blvd
Coldwater, MI 49036
Phone (517) 278-2129

200 Vista Dr
Coldwater, MI 49036
Phone (517) 278-2129

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1283904000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1283904000000",
    "number": "1174830467",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 ORLEANS BLVD",
            "city": "COLDWATER",
            "state": "MI",
            "postal_code": "490361767",
            "telephone_number": "517-278-2129",
            "fax_number": "517-279-8172"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 ORLEANS BLVD",
            "city": "COLDWATER",
            "state": "MI",
            "postal_code": "490361767",
            "telephone_number": "517-278-2129",
            "fax_number": "517-279-8172"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRODT",
        "first_name": "LAURA",
        "middle_name": "L",
        "credential": "M.S.W.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-09-08",
        "last_updated": "2010-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801070618",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Coldwater, MI

Sources for this page

Verify at the official NPI Registry.