Brad K Nyman, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LCSW63280 Issued in CA

Practice address

7355 Church St Ste a
Yucca Valley, CA 92284-3273

Phone

(949) 294-8627

NPI assigned

Sep 25, 2009

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

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

Specialty

Clinical Social Worker

Education

Other, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• The Bodhi Tree, a Licensed Clinical Social Worker Corp

  • Clinical Social Worker
  • Yucca Valley, CA
  • NPI 1831894963
  NPD Authorized official
• Daniel D. Shirbroun, PHD, Inc, Psychologist

  • Clinical Psychologist
  • Yucca Valley, CA
  • NPI 1982607784
  NPD (past)

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

{
    "created_epoch": "1253836800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717113600000",
    "number": "1679807499",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7355 CHURCH ST STE A",
            "city": "YUCCA VALLEY",
            "state": "CA",
            "postal_code": "922843273",
            "telephone_number": "949-294-8627"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7355 CHURCH ST STE A",
            "city": "YUCCA VALLEY",
            "state": "CA",
            "postal_code": "922843273",
            "telephone_number": "949-294-8627"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NYMAN",
        "first_name": "BRAD",
        "middle_name": "K",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-09-25",
        "last_updated": "2024-05-31",
        "certification_date": "2024-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NM",
            "license": "X-06721",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NM",
            "license": "I-07957",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCSW63280",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "136275",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Douglas D Norton
• Harvey C Norton
• Nowysz Regenerative Medicine PC (Center For Regeneration)
• Kendrick Nunez Robles, FNP-C, ENP-C
• Nora L Nunez
• Karmolette O'Gilvie, RN
• Patricia Olguin Sanchez
• Omni Medical Group, Inc.
• Charles Ortiz, ACSW
• Jonathan Ortiz

• Clinical Social Worker in Yucca Valley, CA
• Providers in Yucca Valley, CA by specialty
• Clinical Social Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.