Individual provider Active NPI

Carlos Adair Brown Jr., LMSW-C

  • Clinical Social Worker
  • Kalamazoo, MI
National Provider Identifier
1588110613
Registry record updated Sep 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801114438 Issued in MI
Practice address
418 W Kalamazoo Ave
Kalamazoo, MI 49007-3334
Phone
(269) 553-7066
NPI assigned
Aug 29, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 7, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 6801103956 MI
Clinical Social Worker 1041C0700X 6801114438 MI Primary

Addresses

Primary practice location

418 W Kalamazoo Ave
Kalamazoo, MI 49007-3334

Mailing address

418 W Kalamazoo Ave
Kalamazoo, MI 49007-3334
Phone (269) 553-8066

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
I20221013000905 MI Practitioner - Clinical Social Worker 6507232733

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6801103956MIMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
C&B Well LLC Clinical CurrentSince Aug 26, 2022 Accepting new patients

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": "1472428800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662508800000",
    "number": "1588110613",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "418 W KALAMAZOO AVE",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490073334",
            "telephone_number": "269-553-8066"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "418 W KALAMAZOO AVE",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490073334",
            "telephone_number": "269-553-7066"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN",
        "first_name": "CARLOS",
        "middle_name": "ADAIR",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "LMSW-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-08-29",
        "last_updated": "2022-09-07",
        "certification_date": "2022-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MI",
            "license": "6801103956",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801114438",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kalamazoo, MI

Sources for this page

Verify at the official NPI Registry.