Otha Brown, MSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

6801092030 Issued in MI

Practice address

1115 Ball Ave NE
Grand Rapids, MI 49505-5904

Phone

(616) 459-7215

Fax

(616) 451-0020

NPI assigned

Nov 8, 2010

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1289174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1289174400000",
    "number": "1194026112",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4684 WRIGHTWIND DR SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495466395",
            "telephone_number": "616-648-4444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1115 BALL AVE NE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495055904",
            "telephone_number": "616-459-7215",
            "fax_number": "616-451-0020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN",
        "first_name": "OTHA",
        "name_prefix": "Mr.",
        "credential": "MSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-11-08",
        "last_updated": "2010-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "PA",
            "license": "SW008596",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801092030",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Melanie Ann Brown, LMSW
• Michael D Brown, MD
• Michael Thomas Brown, PAC
• Nakia Brown
• Nicholas Brown
• Pamela Brown
• Patrick Ray Brown, DO
• Rachel Brown, PTA
• Robert Gene Brown, LLPC
• Ryan J Brown, O.D.

• Clinical Social Worker in Grand Rapids, MI
• Providers in Grand Rapids, MI by specialty
• Clinical Social Worker in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2010; 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.