Individual provider Active NPI

Brandon Haydon, L.C.S.W.

  • Clinical Social Worker
  • Skokie, IL
National Provider Identifier
1245699776
Registry record updated Nov 1, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149.018928 Issued in IL
Practice address
8707 Skokie Blvd
Suite 310
Skokie, IL 60077-2269
Phone
(847) 568-1100
NPI assigned
Feb 11, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 1, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 150.015253 IL
Clinical Social Worker 1041C0700X 149.018928 IL Primary

Addresses

Primary practice location

8707 Skokie Blvd
Suite 310
Skokie, IL 60077-2269

Mailing address

8707 Skokie Blvd
Suite 310
Skokie, IL 60077-2269
Phone (847) 568-1100

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
150.015253ILMDSocial Worker
149.018928ILMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1455148800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1477958400000",
    "number": "1245699776",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8707 SKOKIE BLVD",
            "address_2": "SUITE 310",
            "city": "SKOKIE",
            "state": "IL",
            "postal_code": "600772269",
            "telephone_number": "847-568-1100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8707 SKOKIE BLVD",
            "address_2": "SUITE 310",
            "city": "SKOKIE",
            "state": "IL",
            "postal_code": "600772269",
            "telephone_number": "847-568-1100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAYDON",
        "first_name": "BRANDON",
        "credential": "L.C.S.W.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-02-11",
        "last_updated": "2016-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "IL",
            "license": "150.015253",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.018928",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Skokie, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2016; 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.