NPIMap

Organization Active NPI

Carlene J Brockert LLC

  • Community/Behavioral Health Agency
  • Saint Clair Shores, MI
National Provider Identifier
1780248724
Registry record updated Apr 25, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
CARLENE J BROCKERT LLC
Practice address
22309 Mylls St
Saint Clair Shores, MI 48081-1342
Phone
(586) 944-4790
NPI assigned
Apr 25, 2019
Last updated
Apr 25, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 25, 2019

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

Authorized official

Name
Carlene J Brockert, LMSWNPI 1053882118
Title
Owner
Phone
(586) 944-4790

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X Primary

Addresses

Primary practice location

22309 Mylls St
Saint Clair Shores, MI 48081-1342

Mailing address

22309 Mylls St
Saint Clair Shores, MI 48081-1342
Phone (586) 944-4790

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1556150400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1556150400000",
    "number": "1780248724",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22309 MYLLS ST",
            "city": "SAINT CLAIR SHORES",
            "state": "MI",
            "postal_code": "480811342",
            "telephone_number": "586-944-4790"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22309 MYLLS ST",
            "city": "SAINT CLAIR SHORES",
            "state": "MI",
            "postal_code": "480811342",
            "telephone_number": "586-944-4790"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CARLENE J BROCKERT LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-04-25",
        "last_updated": "2019-04-25",
        "status": "A",
        "authorized_official_last_name": "BROCKERT",
        "authorized_official_first_name": "CARLENE",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "586-944-4790",
        "authorized_official_credential": "LMSW"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Clair Shores, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.