Bradley J Redeker, LMSW, LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

BRADLEY J REDEKER, LMSW, LLC

Practice address

3280 E Beltline CT NE Ste 100
Grand Rapids, MI 49525-9494

Phone

(616) 610-9994

NPI assigned

Feb 12, 2020

Organization subpart

No

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

Authorized official

Name

Mr. Bradley Redeker, LMSW, APBCC, CCTP

Title

Clinical Social Worker

Phone

(616) 258-0687

Specialties & licenses 1

Addresses

Electronic endpoints 1

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

{
    "created_epoch": "1581465600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1582329600000",
    "number": "1801429378",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5510 LILLY CT SW",
            "city": "WYOMING",
            "state": "MI",
            "postal_code": "495099204",
            "telephone_number": "616-258-0687"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3280 E BELTLINE CT NE STE 100",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495259494",
            "telephone_number": "616-610-9994"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRADLEY J REDEKER, LMSW, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-02-12",
        "last_updated": "2020-02-22",
        "certification_date": "2020-02-22",
        "status": "A",
        "authorized_official_last_name": "REDEKER",
        "authorized_official_first_name": "BRADLEY",
        "authorized_official_title_or_position": "CLINICAL SOCIAL WORKER",
        "authorized_official_telephone_number": "616-258-0687",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LMSW, APBCC, CCTP"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "bredeker@northeastgrcounseling.com",
            "affiliation": "N",
            "endpointDescription": "email address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "3280 E Beltline Ct NE Ste 100",
            "city": "Grand Rapids",
            "state": "MI",
            "country_code": "US",
            "postal_code": "495259494",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Jonathan Edward Bradd, NP
• Mark David Braden Jr., DO
• Nikia Joy Braden
• Alyssa Bradfield, DO
• Bradley Bengtson, M.D. PC
• Abigail Marie Bradley, LMSW
• Amanda Jo Bradley, LPN
• Barbara J Bradley, MD
• Erica Lynn Bradley, LMSW
• Louise Bradley

• Clinical Social Worker in Grand Rapids, MI
• Providers in Grand Rapids, MI by specialty
• Clinical Social Worker in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2020; 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.