Active NPI
Brenda Lee Michael, LCSW
- Clinical Social Worker
- Wilmington, NC
National Provider Identifier
1528125259
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- C003296
- Practice address
- 311-4E Judges Road
Wilmington, NC 28405-3655 - Phone
- (910) 791-6767
- Fax
- (910) 791-6890
- NPI assigned
- Jan 2, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | C003296 | NC | |
| Clinical Social Worker | 1041C0700X | C003296 | NC | Primary |
Addresses
Primary practice location
311-4E Judges Road
Wilmington, NC 28405-3655
Mailing address
311-4E Judges Road
Wilmington, NC 28405-3655
Phone (910) 791-6767
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| P00813768 | Other | NC | RR MEDICARE |
| 6002054 | Medicaid | NC |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| C003296 | NC | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Act Medical Group PA | Past | Accepting new patients | |
| Assistedcare, Inc | Past | Accepting new patients | |
| Act Medical Group, PA | Past | Accepting new patients |
Organizations & group practices 3
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.
-
- Specialist
- Wilmington, NC
- NPI 1245219799
-
- Family Medicine Physician
- Wilmington, NC
- NPI 1598982860
-
- Home Health Agency
- Leland, NC
- NPI 1821193103
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1167696000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1332115200000",
"number": "1528125259",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "311-4E JUDGES ROAD",
"city": "WILMINGTON",
"state": "NC",
"postal_code": "284053655",
"telephone_number": "910-791-6767",
"fax_number": "910-791-6890"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "311-4E JUDGES ROAD",
"city": "WILMINGTON",
"state": "NC",
"postal_code": "284053655",
"telephone_number": "910-791-6767",
"fax_number": "910-791-6890"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MICHAEL",
"first_name": "BRENDA",
"middle_name": "LEE",
"name_prefix": "Mrs.",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-01-02",
"last_updated": "2012-03-19",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "NC",
"license": "C003296",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NC",
"license": "C003296",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RR MEDICARE",
"identifier": "P00813768",
"state": "NC"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "6002054",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Wilmington, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.