Individual provider Active NPI

Garth Allan Brittenham, LMSW

  • Clinical Social Worker
  • Monroe, MI
National Provider Identifier
1619475985
Registry record updated Jan 31, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801088425 Issued in MI
Practice address
1101 S Raisinville Rd
Monroe, MI 48161-9047
Phone
(734) 342-8413
NPI assigned
Jan 31, 2018
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 31, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 6801088425 MI Primary

Addresses

Primary practice location

1101 S Raisinville Rd
Monroe, MI 48161-9047

Mailing address

1101 S Raisinville Rd
Monroe, MI 48161-9047
Phone (734) 342-8413

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
I20260421000171 MI Practitioner - Clinical Social Worker 8325514979 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6801088425MIMDClinical Social 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.

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Monroe County Community Mental Health Authority 8 clinicians

Practice addresses (Care Compare)

1001 S Raisinville Rd
Monroe, MI 48161-9754
Phone (734) 243-7340

NPI Registry JSON

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

{
    "created_epoch": "1517356800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1517356800000",
    "number": "1619475985",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1101 S RAISINVILLE RD",
            "city": "MONROE",
            "state": "MI",
            "postal_code": "481619047",
            "telephone_number": "734-342-8413"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 S RAISINVILLE RD",
            "city": "MONROE",
            "state": "MI",
            "postal_code": "481619047",
            "telephone_number": "734-342-8413"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRITTENHAM",
        "first_name": "GARTH",
        "middle_name": "ALLAN",
        "credential": "LMSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-01-31",
        "last_updated": "2018-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801088425",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Monroe, MI

Sources for this page

Verify at the official NPI Registry.