Individual provider Active NPI

Breanne Ludington, LMSW

  • Clinical Social Worker
  • Okemos, MI
National Provider Identifier
1821406315
Registry record updated Feb 18, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801096727 Issued in MI
Practice address
2149 Jolly Rd Ste 500
Okemos, MI 48864-6028
Phone
(517) 347-4645
NPI assigned
Jul 28, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 18, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 6801096727
Clinical Social Worker 1041C0700X 6801096727 MI Primary

Addresses

Primary practice location

2149 Jolly Rd Ste 500
Okemos, MI 48864-6028

Mailing address

2149 Jolly Rd Ste 500
Okemos, MI 48864-6028

Other practice location 1

1206 Clinton Rd
Jackson, MI 49202-2005
Phone (517) 783-4250

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

NPI Registry JSON

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

{
    "created_epoch": "1406505600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1550448000000",
    "number": "1821406315",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2149 JOLLY RD STE 500",
            "city": "OKEMOS",
            "state": "MI",
            "postal_code": "488646028"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2149 JOLLY RD STE 500",
            "city": "OKEMOS",
            "state": "MI",
            "postal_code": "488646028",
            "telephone_number": "517-347-4645"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1206 Clinton Rd",
            "address_purpose": "LOCATION",
            "city": "Jackson",
            "state": "MI",
            "postal_code": "492022005",
            "country_code": "US",
            "telephone_number": "517-783-4250",
            "fax_number": "517-783-4164",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LUDINGTON",
        "first_name": "BREANNE",
        "credential": "LMSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-07-28",
        "last_updated": "2019-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": "6801096727",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801096727",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Okemos, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 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.