Michael W. Bradburn, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

149.008325 Issued in IL

Practice address

1819 Bay Scott Cir
Suite 109
Naperville, IL 60540-1129

Phone

(630) 357-2456

Fax

(630) 357-2482

NPI assigned

Aug 6, 2010

Last updated

Aug 1, 2013By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

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

Specialty

Clinical Social Worker

Education

Other, 1995

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Samaritan Interfaith Counseling Center IncGroup PAC ID 8426014994, 19 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Samaritan Interfaith Counseling Center Inc.

  • Clinical Psychologist
  • Naperville, IL
  • NPI 1497842983
  Medicare reassignment Care Compare group
• Samaritan Counseling Center

  • Marriage & Family Therapist
  • Winnetka, IL
  • NPI 1841397353

  Counselor

  NPD (past)

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

{
    "created_epoch": "1281052800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1375315200000",
    "number": "1205140811",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1819 BAY SCOTT CIR",
            "address_2": "SUITE 109",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605401129",
            "telephone_number": "630-357-2456",
            "fax_number": "630-357-2482"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1819 BAY SCOTT CIR",
            "address_2": "SUITE 109",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605401129",
            "telephone_number": "630-357-2456",
            "fax_number": "630-357-2482"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRADBURN",
        "first_name": "MICHAEL",
        "middle_name": "W.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-08-06",
        "last_updated": "2013-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP1600X",
            "taxonomy_group": "",
            "desc": "Counselor, Pastoral",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.008325",
            "primary": true
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sophie Elizabeth Bouton, PA-C
• Nicole Anne Bowers, PA-C
• Rebecca Eileen Boyce, AU.D.
• Elizabeth Ann Boyle, DO
• Kathryn Boyle
• Tara Bradbury
• Brain Balance Cin
• Sandra Braine, L.C.S.W.
• Meghan Bramer, PA-C
• Cynthia Bran, LPC

• Clinical Social Worker in Naperville, IL
• Providers in Naperville, IL by specialty
• Clinical Social Worker in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.