Individual provider Active NPI

Brenda Kay Bryant, LMSW

  • Clinical Social Worker
  • Pontiac, MI
National Provider Identifier
1356445902
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801058936 Issued in MI
Practice address
28 N Saginaw St
Suite 813
Pontiac, MI 48342-2134
Phone
(248) 451-0540
Fax
(248) 451-0544
NPI assigned
Sep 12, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 6801058936 MI Primary

Addresses

Primary practice location

28 N Saginaw St
Suite 813
Pontiac, MI 48342-2134

Mailing address

28 N Saginaw St
Suite 813
Pontiac, MI 48342-2134
Phone (248) 451-0540

Other identifiers 1

IdentifierTypeStateIssuer
8008970060OtherBLUE CROSS BLUE SHIELD

Other names 1

  • Ms. Brenda Kay Mitchell Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20040618000736 MI Practitioner - Clinical Social Worker 4587649231 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2240 E Hill Rd
Suite F
Grand Blanc, MI 48439-5425
Phone (248) 897-5190

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Lakeview Family Counseling Center LLC Current Accepting new patients
Soka Services Clinical Past Accepting new patients

Locations

2240 E Hill Rd
Ste F
Grand Blanc, MI 48439
Phone (248) 904-7093

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1158019200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1356445902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28 N SAGINAW ST",
            "address_2": "SUITE 813",
            "city": "PONTIAC",
            "state": "MI",
            "postal_code": "483422134",
            "telephone_number": "248-451-0540",
            "fax_number": "248-451-0544"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28 N SAGINAW ST",
            "address_2": "SUITE 813",
            "city": "PONTIAC",
            "state": "MI",
            "postal_code": "483422134",
            "telephone_number": "248-451-0540",
            "fax_number": "248-451-0544"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRYANT",
        "first_name": "BRENDA",
        "middle_name": "KAY",
        "name_prefix": "Mrs.",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801058936",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "8008970060",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BRENDA",
            "last_name": "MITCHELL",
            "middle_name": "KAY",
            "prefix": "MS.",
            "credential": "LMSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Pontiac, MI

Sources for this page

Verify at the official NPI Registry.