Individual provider Active NPI

Breana Lewis, LLMSW

  • Clinical Social Worker
  • Warren, MI
National Provider Identifier
1356924948
Registry record updated Apr 30, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801107462 Issued in MI
Practice address
11480 E 13 Mile Rd
Warren, MI 48093-2566
Phone
(586) 216-9253
NPI assigned
Apr 30, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 30, 2021

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 6801107462 MI Primary

Addresses

Primary practice location

11480 E 13 Mile Rd
Warren, MI 48093-2566

Mailing address

13524 Stamford Rd
Van Buren TWP, MI 48111-1396
Phone (734) 635-9551

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
I20230701000258 MI Practitioner - Clinical Social Worker 7012376577 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6801107462MIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
International Therapy Solutions, PLLC Clinical CurrentSince Jun 19, 2023 Accepting new patients

Locations

11480 E 13 Mile Rd
Warren, MI 48093
Phone (586) 216-9253

Organizations & group practices 1

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": "1619740800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619740800000",
    "number": "1356924948",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13524 STAMFORD RD",
            "city": "VAN BUREN TWP",
            "state": "MI",
            "postal_code": "481111396",
            "telephone_number": "734-635-9551"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11480 E 13 MILE RD",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "480932566",
            "telephone_number": "586-216-9253"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEWIS",
        "first_name": "BREANA",
        "credential": "LLMSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-04-30",
        "last_updated": "2021-04-30",
        "certification_date": "2021-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801107462",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Warren, MI

Sources for this page

Verify at the official NPI Registry.