Brenda Marie Ennis, MSW; DCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

6801085534 Issued in MI

Practice address

2202 Mitchell Park Dr
Suite 2B
Petoskey, MI 49770-8897

Phone

(231) 487-1750

Fax

(231) 487-1754

NPI assigned

Dec 1, 2009

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Specialty

Clinical Social Worker

Education

Other, 1998

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Mosaic Center for Integrative Therapy, LLC

  • Community/Behavioral Health Agency
  • Petoskey, MI
  • NPI 1518208008
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1259625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1382313600000",
    "number": "1386972446",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2202 MITCHELL PARK DR",
            "address_2": "SUITE 2B",
            "city": "PETOSKEY",
            "state": "MI",
            "postal_code": "497708897",
            "telephone_number": "231-487-1750",
            "fax_number": "231-487-1754"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2202 MITCHELL PARK DR",
            "address_2": "SUITE 2B",
            "city": "PETOSKEY",
            "state": "MI",
            "postal_code": "497708897",
            "telephone_number": "231-487-1750",
            "fax_number": "231-487-1754"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ENNIS",
        "first_name": "BRENDA",
        "middle_name": "MARIE",
        "name_prefix": "Ms.",
        "credential": "MSW; DCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-12-01",
        "last_updated": "2013-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801085534",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Margaret-Anne Endlein, DPT, ATC
• Deanna Marie Engelhart, FNP-C
• Max Harris Engelman, OD
• Katelyn Engler
• Daniel Paul Engstrom, RPH
• Eric J Mancini MD, PC
• Benjamin Joel Ernsberger
• Eugene P Wang, DO PC
• Victoria Fairbairn
• Family Psychological Services

• Clinical Social Worker in Petoskey, MI
• Providers in Petoskey, 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 Oct 21, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.