Individual provider Active NPI

Brooke C Davis, L.M.S.W.

  • Clinical Social Worker
  • Muskegon, MI
National Provider Identifier
1780969907
Registry record updated Oct 19, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801092789 Issued in MI
Practice address
1095 3Rd St
Muskegon, MI 49441-1976
Phone
(231) 726-4735
Fax
(231) 722-0789
NPI assigned
Oct 19, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 19, 2011

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 6801092789 MI Primary

Addresses

Primary practice location

1095 3Rd St
Muskegon, MI 49441-1976

Mailing address

1095 3Rd St
Muskegon, MI 49441-1976
Phone (231) 726-4735

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

LicenseStateTypeSpecialty
6801092789MIMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1318982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1318982400000",
    "number": "1780969907",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1095 3RD ST",
            "city": "MUSKEGON",
            "state": "MI",
            "postal_code": "494411976",
            "telephone_number": "231-726-4735",
            "fax_number": "231-722-0789"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1095 3RD ST",
            "city": "MUSKEGON",
            "state": "MI",
            "postal_code": "494411976",
            "telephone_number": "231-726-4735",
            "fax_number": "231-722-0789"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "BROOKE",
        "middle_name": "C",
        "credential": "L.M.S.W.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-10-19",
        "last_updated": "2011-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801092789",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Muskegon, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2011; 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.