Keith David Bogucki, LLMSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

6801101915 Issued in MI

Practice address

1049 Newell
P.O. Box 867
White Cloud, MI 49349

Phone

(231) 689-7330

NPI assigned

Feb 26, 2018

Last updated

Feb 26, 2018By 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 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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.

• Newaygo County Mental Health Board

  dba Newaygo County Mental Health

  • Community/Behavioral Health Agency
  • White Cloud, MI
  • NPI 1376512236
  NPD (past)
• Newaygo County Mental Health Board

  dba Newaygo County Mental Health

  • Psychiatry Physician
  • White Cloud, MI
  • NPI 1386969996
  NPD (past)

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

{
    "created_epoch": "1519603200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1519603200000",
    "number": "1306347356",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1049 E NEWELL ST",
            "city": "WHITE CLOUD",
            "state": "MI",
            "postal_code": "493498795",
            "telephone_number": "231-689-7330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1049 NEWELL",
            "address_2": "P.O. BOX 867",
            "city": "WHITE CLOUD",
            "state": "MI",
            "postal_code": "49349",
            "telephone_number": "231-689-7330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOGUCKI",
        "first_name": "KEITH",
        "middle_name": "DAVID",
        "credential": "LLMSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-02-26",
        "last_updated": "2018-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801101915",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jerren Benton
• Amber Lynne Bergman
• Jenniffer Bignall, RDH
• Annette Binnendyk, LMSW
• Andrea Leigh Bliss
• Katerina Bremer
• Chris P Briggs, L.B.S.W.
• John George Briggs, M.D.
• Lisa Marie Briggs, R.N.
• Kristin E Brookhouse, LMSW

• Clinical Social Worker in White Cloud, MI
• Providers in White Cloud, MI by specialty
• Clinical Social Worker in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2018; 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.