Individual provider Active NPI

Katherine Brandon, LMSW

  • Clinical Social Worker
  • Ypsilanti, MI
National Provider Identifier
1205504347
Registry record updated Sep 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801066811 Issued in MI
Practice address
1795 Sheffield Dr
Ypsilanti, MI 48198-3633
Phone
(734) 604-2745
NPI assigned
Sep 2, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 2, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X 6801066811 MI Primary

Addresses

Primary practice location

1795 Sheffield Dr
Ypsilanti, MI 48198-3633

Mailing address

1795 Sheffield Dr
Ypsilanti, MI 48198-3633
Phone (734) 604-2745

Other identifiers 1

IdentifierTypeStateIssuer
6801066811OtherMISTATE OF MICHIGAN LICENSE

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
6801066811MIMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1630540800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630540800000",
    "number": "1205504347",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1795 SHEFFIELD DR",
            "city": "YPSILANTI",
            "state": "MI",
            "postal_code": "481983633",
            "telephone_number": "734-604-2745"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1795 SHEFFIELD DR",
            "city": "YPSILANTI",
            "state": "MI",
            "postal_code": "481983633",
            "telephone_number": "734-604-2745"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRANDON",
        "first_name": "KATHERINE",
        "credential": "LMSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-09-02",
        "last_updated": "2021-09-02",
        "certification_date": "2021-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801066811",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE OF MICHIGAN LICENSE",
            "identifier": "6801066811",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ypsilanti, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2021; 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.