Active NPI
Michael J Bradley, LBSW
- Social Worker
- Flint, MI
National Provider Identifier
1356560148
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 6802085827
- Practice address
- 420 W 5TH Ave
Flint, MI 48503-2445 - Phone
- (810) 257-3740
- NPI assigned
- Apr 24, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 6802085827 | MI | Primary |
Addresses
Primary practice location
420 W 5TH Ave
Flint, MI 48503-2445
Mailing address
420 W 5TH Ave
Flint, MI 48503-2445
Phone (810) 257-3740
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 211075242 | Medicaid | MI |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 6802085827 | MI | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1177372800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1491264000000",
"number": "1356560148",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "420 W 5TH AVE",
"city": "FLINT",
"state": "MI",
"postal_code": "485032445",
"telephone_number": "810-257-3740"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "420 W 5TH AVE",
"city": "FLINT",
"state": "MI",
"postal_code": "485032445",
"telephone_number": "810-257-3740"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRADLEY",
"first_name": "MICHAEL",
"middle_name": "J",
"name_prefix": "Mr.",
"credential": "LBSW",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-04-24",
"last_updated": "2017-04-04",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "MI",
"license": "6802085827",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "211075242",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Flint, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.