Individual provider Active NPI

Brandon White, LLMSW

  • Social Worker
  • Warren, MI
National Provider Identifier
1477045839
Registry record updated Jun 1, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
6801102509 Issued in MI
Practice address
30101 Hoover Rd Ste 1
Warren, MI 48093-6572
Phone
(586) 558-6868
NPI assigned
Jun 1, 2018
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 1, 2018

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 6801102509 MI Primary

Addresses

Primary practice location

30101 Hoover Rd Ste 1
Warren, MI 48093-6572

Mailing address

46941 Crestview Dr
Macomb, MI 48044-3203
Phone (586) 291-1833

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20230802000300 MI Practitioner - Clinical Social Worker 1052772464 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Wayne State University School of Medicine, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lapeer Christian Counseling LLCGroup PAC ID 5294063004, 9 clinicians

Practice addresses (Care Compare)

778 S Main St
Suite 121
Lapeer, MI 48446-3032

814 S Main St
Suite 3
Lapeer, MI 48446-3073
Phone (810) 660-8275

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6801102509MIMDSocial Worker

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1527811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1527811200000",
    "number": "1477045839",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "46941 CRESTVIEW DR",
            "city": "MACOMB",
            "state": "MI",
            "postal_code": "480443203",
            "telephone_number": "586-291-1833"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30101 HOOVER RD STE 1",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "480936572",
            "telephone_number": "586-558-6868"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITE",
        "first_name": "BRANDON",
        "credential": "LLMSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-06-01",
        "last_updated": "2018-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MI",
            "license": "6801102509",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Warren, MI

Sources for this page

Verify at the official NPI Registry.