Individual provider Active NPI

Lauren Renee Bresky, LLMSW

  • Social Worker
  • Clinton Township, MI
National Provider Identifier
1447068093
Registry record updated Dec 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
6851118794 Issued in MI
Practice address
15930 19 Mile Rd Ste 150
Clinton Township, MI 48038-1155
Phone
(586) 281-5866
NPI assigned
Dec 27, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 27, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 6851118794 MI Primary

Addresses

Primary practice location

15930 19 Mile Rd Ste 150
Clinton Township, MI 48038-1155

Mailing address

15930 19 Mile Rd Ste 150
Clinton Township, MI 48038-1155

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
6851118794MIMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Ellie Sem Clinic, PLLC CurrentSince Dec 29, 2024 Accepting new patients
Macomb Oakland Regional Center Inc. PastSince Dec 29, 2024 Accepting new patients

Locations

15930 19 Mile Rd
Ste 150
Clinton Twp, MI 48038
Phone (586) 281-5866

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": "1735257600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735257600000",
    "number": "1447068093",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15930 19 MILE RD STE 150",
            "city": "CLINTON TOWNSHIP",
            "state": "MI",
            "postal_code": "480381155"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15930 19 MILE RD STE 150",
            "city": "CLINTON TOWNSHIP",
            "state": "MI",
            "postal_code": "480381155",
            "telephone_number": "586-281-5866"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRESKY",
        "first_name": "LAUREN",
        "middle_name": "RENEE",
        "credential": "LLMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-12-27",
        "last_updated": "2024-12-27",
        "certification_date": "2024-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MI",
            "license": "6851118794",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clinton Township, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2024; 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.