Individual provider Active NPI

Brandi Clayton

  • Clinical Social Worker
  • Frederick, MD
National Provider Identifier
1346885886
Registry record updated Nov 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
22197 Issued in MD
Practice address
128 S Market St Apt 4
Frederick, MD 21701-6972
Phone
(443) 902-1725
NPI assigned
Nov 7, 2019
Last updated
Nov 6, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 6, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 22197 MD Primary

Addresses

Primary practice location

128 S Market St Apt 4
Frederick, MD 21701-6972

Mailing address

16110 Myriad LN Apt 204
Fort Myers, FL 33908-3172
Phone (443) 902-1725

Other identifiers 1

IdentifierTypeStateIssuer
NONEOtherNONE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
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

Enrollment IDStateProvider typePAC IDDetails
I20210308000761 MD Practitioner - Clinical Social Worker 9931515582

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
22197MDMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Be-Live-It Therapy PastSince Mar 16, 2021 Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1573084800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730851200000",
    "number": "1346885886",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16110 MYRIAD LN APT 204",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339083172",
            "telephone_number": "443-902-1725"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "128 S MARKET ST APT 4",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217016972",
            "telephone_number": "443-902-1725"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLAYTON",
        "first_name": "BRANDI",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-11-07",
        "last_updated": "2024-11-06",
        "certification_date": "2024-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MD",
            "license": "22197",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NONE",
            "identifier": "NONE",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Frederick, MD

Sources for this page

Verify at the official NPI Registry.