Kandyce Kaye Brink, M.A. L.M.S.W. L.P.C

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

6801060472 Issued in MI

Practice address

1804 Colfax Ave Ste 1
Benton Harbor, MI 49022-6711

Phone

(269) 983-5600

Fax

(269) 927-6146

NPI assigned

Aug 24, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1156377600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1393804800000",
    "number": "1376650507",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 553",
            "city": "SAINT JOSEPH",
            "state": "MI",
            "postal_code": "490850553",
            "telephone_number": "269-983-5600",
            "fax_number": "269-927-6146"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1804 COLFAX AVE STE 1",
            "city": "BENTON HARBOR",
            "state": "MI",
            "postal_code": "490226711",
            "telephone_number": "269-983-5600",
            "fax_number": "269-927-6146"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRINK",
        "first_name": "KANDYCE",
        "middle_name": "KAYE",
        "name_prefix": "Ms.",
        "credential": "M.A. L.M.S.W.  L.P.C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-24",
        "last_updated": "2014-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MI",
            "license": "6401002128",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801060472",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Coral Anne Brenneise, MSW
• Bridges
• Bridges of Courage Counseling, LLC
• Cynthia A Bridgman, LMSW
• Laura Michelle Brimer
• Theresa Louise Britton, LMSW
• Evie Noel Bronson
• Jessica J Brooks, LLMSW
• Belinda Faye Brown, LPN
• Charmaine Brown

• Clinical Social Worker in Benton Harbor, MI
• Providers in Benton Harbor, MI by specialty
• Clinical Social Worker in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2014; 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.