Brandi Rose Sickmund, LLMSW

Primary specialty

Social WorkerTaxonomy code 104100000X

License

6851110625 Issued in MI

Practice address

12130 Fillmore St
West Olive, MI 49460-8985

Phone

(616) 786-4140

NPI assigned

Mar 10, 2015

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

Other names 1

• Brandi Rose Tenhoopen Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Kent County CMH Authority

  • Community/Behavioral Health Agency
  • Grand Rapids, MI
  • NPI 1194617811
  NPD (past)
• Thresholds Inc

  • Case Management Agency
  • Grand Rapids, MI
  • NPI 1154403467
  NPD (past)

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

{
    "created_epoch": "1425945600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627948800000",
    "number": "1376936708",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12130 FILLMORE ST",
            "city": "WEST OLIVE",
            "state": "MI",
            "postal_code": "494608985",
            "telephone_number": "616-786-4140"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12130 FILLMORE ST",
            "city": "WEST OLIVE",
            "state": "MI",
            "postal_code": "494608985",
            "telephone_number": "616-786-4140"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SICKMUND",
        "first_name": "BRANDI",
        "middle_name": "ROSE",
        "credential": "LLMSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-03-10",
        "last_updated": "2021-08-03",
        "certification_date": "2021-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MI",
            "license": "6802088480",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MI",
            "license": "6851110625",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BRANDI",
            "last_name": "TENHOOPEN",
            "middle_name": "ROSE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Jack Richard Roossien Jr., M.D.
• Jessica Lynn Roossien, FNP-BC
• Lindsey Ann Roossien, PA-C
• Mercedes B Saurbaugh, LMSW
• Patrick Schaafsma, LMSW
• Sides Psychological Consulting, LLC
• Justin Sides, PSYD
• Thomas Anson Smith, M.D.
• Stanton Crossings Physical Therapy LLC
• Matthew Tornga, D.O.

• Social Worker in West Olive, MI
• Providers in West Olive, MI by specialty
• Social Worker in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2021; 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.