Jacob Bradley Lydick, LLMSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

6851122364 Issued in MI

Practice address

3300 Washtenaw Ave Ste 260
Ann Arbor, MI 48104-5184

Phone

(734) 276-5772

NPI assigned

Jun 3, 2026

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1780444800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780444800000",
    "number": "1841123692",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1305 S CONGRESS ST APT 211",
            "city": "YPSILANTI",
            "state": "MI",
            "postal_code": "481974545"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3300 WASHTENAW AVE STE 260",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481045184",
            "telephone_number": "734-276-5772"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LYDICK",
        "first_name": "JACOB",
        "middle_name": "BRADLEY",
        "credential": "LLMSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2026-06-03",
        "last_updated": "2026-06-03",
        "certification_date": "2026-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6851122364",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Cristina M Raphaela Luzio de Moeller, LLMSW
• Matthew James Luzum, M.D.
• Teresa H Lyden, M.A., CCC-SLP
• Kortnie Michele Lyell, CPHT
• Amy Marie Lykins, RN
• Evan Brady Lynch, MD, PHD
• Janet Lynch
• William Robert Lynch, MD

• Clinical Social Worker in Ann Arbor, MI
• Providers in Ann Arbor, 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 Jun 3, 2026; 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.