Individual provider Active NPI

Marilyn Jean Brabant, LMSW, CAADC

  • Social Worker
  • Saginaw, MI
National Provider Identifier
1750411336
Registry record updated Aug 16, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
6801086497 Issued in MI
Practice address
3023 Davenport Ave
Saginaw, MI 48602-3652
Phone
(989) 907-9072
Fax
(989) 907-2762
NPI assigned
Mar 6, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 16, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 6801086497 MI Primary

Addresses

Primary practice location

3023 Davenport Ave
Saginaw, MI 48602-3652

Mailing address

3023 Davenport Ave
Saginaw, MI 48602-3652
Phone (989) 907-2761

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
I20180110000106 MI Practitioner - Clinical Social Worker 4183983554 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6801086497MIMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Victory Clinical Services IV, LLC PastSince Jun 2, 2012 Accepting new patients

Organizations & group practices 2

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": "1173139200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565913600000",
    "number": "1750411336",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3023 DAVENPORT AVE",
            "city": "SAGINAW",
            "state": "MI",
            "postal_code": "486023652",
            "telephone_number": "989-907-2761",
            "fax_number": "989-907-2762"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3023 DAVENPORT AVE",
            "city": "SAGINAW",
            "state": "MI",
            "postal_code": "486023652",
            "telephone_number": "989-907-9072",
            "fax_number": "989-907-2762"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRABANT",
        "first_name": "MARILYN",
        "middle_name": "JEAN",
        "name_prefix": "Ms.",
        "credential": "LMSW, CAADC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-06",
        "last_updated": "2019-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MI",
            "license": "6801086497",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saginaw, MI

Sources for this page

Verify at the official NPI Registry.