Individual provider Active NPI

Levaughn Westbrook, LMSW

  • Clinical Social Worker
  • Fenton, MI
National Provider Identifier
1417398579
Registry record updated Jul 3, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801096198 Issued in MI
Practice address
1537 N Leroy St
Fenton, MI 48430-2795
Phone
(703) 782-9298
NPI assigned
Jul 17, 2013
Last updated
Jul 3, 2019By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 3, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 0904009408 VA
Clinical Social Worker 1041C0700X 6801096198 MI Primary

Addresses

Primary practice location

1537 N Leroy St
Fenton, MI 48430-2795

Mailing address

11426 Davis St Unit 1032
Grand Blanc, MI 48480-8542
Phone (703) 782-9298

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, VA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20160623000365 DC Practitioner - Clinical Social Worker 8628369568 Reassigns benefits to 1 organization
I20160628002611 VA Practitioner - Clinical Social Worker 8628369568 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6801096198MIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Live Your Life Counseling & Treatment Services LLC Clinical Current Accepting new patients

Locations

11426 Davis St
Unit 1032
Grand Blanc, MI 48480

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1374019200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1562112000000",
    "number": "1417398579",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11426 DAVIS ST UNIT 1032",
            "city": "GRAND BLANC",
            "state": "MI",
            "postal_code": "484808542",
            "telephone_number": "703-782-9298"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1537 N LEROY ST",
            "city": "FENTON",
            "state": "MI",
            "postal_code": "484302795",
            "telephone_number": "703-782-9298"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WESTBROOK",
        "first_name": "LEVAUGHN",
        "name_prefix": "Mrs.",
        "credential": "LMSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-07-17",
        "last_updated": "2019-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "0904009408",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801096198",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fenton, MI

Sources for this page

Verify at the official NPI Registry.