Active NPI
Brandan Mitchell
- Social Worker
- Kalamazoo, MI
National Provider Identifier
1598168932
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 6801096545
- Practice address
- 821 W South St Ste B
Kalamazoo, MI 49007-4664 - Phone
- (269) 205-8566
- Fax
- (269) 585-5954
- NPI assigned
- Sep 30, 2014
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 6801096545 | MI | Primary |
Addresses
Primary practice location
821 W South St Ste B
Kalamazoo, MI 49007-4664
Mailing address
PO Box 10
Mason, MI 48854-0010
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 |
|---|---|---|---|
| 6801096545 | MI | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1412035200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1608076800000",
"number": "1598168932",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 10",
"city": "MASON",
"state": "MI",
"postal_code": "488540010"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "821 W SOUTH ST STE B",
"city": "KALAMAZOO",
"state": "MI",
"postal_code": "490074664",
"telephone_number": "269-205-8566",
"fax_number": "269-585-5954"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MITCHELL",
"first_name": "BRANDAN",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2014-09-30",
"last_updated": "2020-12-16",
"certification_date": "2020-12-16",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "MI",
"license": "6801096545",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Kalamazoo, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.