Individual provider Active NPI

Daphne Brydon, LMSW, PHD

  • Clinical Social Worker
  • Ann Arbor, MI
National Provider Identifier
1356117287
Registry record updated Dec 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801091896 Issued in MI
Practice address
2155 Jackson Ave Ste 1
Ann Arbor, MI 48103-3976
Phone
(734) 272-5634
NPI assigned
Dec 1, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 1, 2023

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 6801091896 MI Primary

Addresses

Primary practice location

2155 Jackson Ave Ste 1
Ann Arbor, MI 48103-3976

Mailing address

901 Pine Tree Dr
Ann Arbor, MI 48103-2565

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
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
6801091896MIMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1701388800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701388800000",
    "number": "1356117287",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "901 PINE TREE DR",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481032565"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2155 JACKSON AVE STE 1",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481033976",
            "telephone_number": "734-272-5634"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRYDON",
        "first_name": "DAPHNE",
        "name_prefix": "Dr.",
        "credential": "LMSW, PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-12-01",
        "last_updated": "2023-12-01",
        "certification_date": "2023-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801091896",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ann Arbor, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2023; 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.