Individual provider Active NPI

Bradley Allen, LLMSW

  • Social Worker
  • Lansing, MI
National Provider Identifier
1194315465
Registry record updated Jan 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
6801101393 Issued in MI
Practice address
812 E Jolly Rd Ste 210
Lansing, MI 48910-6825
Phone
(517) 346-8275
NPI assigned
Jan 21, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 21, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 6801101393 MI Primary

Addresses

Primary practice location

812 E Jolly Rd Ste 210
Lansing, MI 48910-6825

Mailing address

812 E Jolly Rd Ste 210
Lansing, MI 48910-6825

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
I20230207000785 MI Practitioner - Clinical Social Worker 0547632275 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6801101393MIMDSocial 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": "1611187200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611187200000",
    "number": "1194315465",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "812 E JOLLY RD STE 210",
            "city": "LANSING",
            "state": "MI",
            "postal_code": "489106825"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "812 E JOLLY RD STE 210",
            "city": "LANSING",
            "state": "MI",
            "postal_code": "489106825",
            "telephone_number": "517-346-8275"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALLEN",
        "first_name": "BRADLEY",
        "credential": "LLMSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-01-21",
        "last_updated": "2021-01-21",
        "certification_date": "2021-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MI",
            "license": "6801101393",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lansing, MI

Sources for this page

Verify at the official NPI Registry.