Active NPI
Bradford Paul Bordini, LCSW
- Clinical Social Worker
- Green Bay, WI
National Provider Identifier
1235384389
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 7357-123
- Practice address
- 301 E Saint Joseph St
Green Bay, WI 54301-2241 - Phone
- (920) 433-3630
- NPI assigned
- Nov 17, 2008
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 7357-123 | WI | Primary |
Addresses
Primary practice location
301 E Saint Joseph St
Green Bay, WI 54301-2241
Mailing address
301 E Saint Joseph St
Green Bay, WI 54301-2241
Phone (920) 433-3630
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| PENDING | Medicaid | WI |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 7357-123 | WI | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1226880000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1612915200000",
"number": "1235384389",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "301 E SAINT JOSEPH ST",
"city": "GREEN BAY",
"state": "WI",
"postal_code": "543012241",
"telephone_number": "920-433-3630"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "301 E SAINT JOSEPH ST",
"city": "GREEN BAY",
"state": "WI",
"postal_code": "543012241",
"telephone_number": "920-433-3630"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BORDINI",
"first_name": "BRADFORD",
"middle_name": "PAUL",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-11-17",
"last_updated": "2021-02-10",
"certification_date": "2021-02-10",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "WI",
"license": "7357-123",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "PENDING",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Green Bay, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 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.