Individual provider Active NPI

Lesly Lebrun, MSW

  • Social Worker
  • Benton Harbor, MI
National Provider Identifier
1851628374
Registry record updated Jul 27, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
6801089952 Issued in MI
Practice address
800 M-139
Benton Harbor, MI 49022-4843
Phone
(269) 927-5400
Fax
(269) 927-5493
NPI assigned
Nov 4, 2009
Last updated
Jul 27, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 27, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 6801089952 MI Primary

Addresses

Primary practice location

800 M-139
Benton Harbor, MI 49022-4843

Mailing address

50 Industrial Park Rd
Bangor, MI 49013-1246
Phone (269) 427-7937

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
6801089952MIMDSocial Worker

NPI Registry JSON

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

{
    "created_epoch": "1257292800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1311724800000",
    "number": "1851628374",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50 INDUSTRIAL PARK RD",
            "city": "BANGOR",
            "state": "MI",
            "postal_code": "490131246",
            "telephone_number": "269-427-7937",
            "fax_number": "269-427-5180"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 M-139",
            "city": "BENTON HARBOR",
            "state": "MI",
            "postal_code": "490224843",
            "telephone_number": "269-927-5400",
            "fax_number": "269-927-5493"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEBRUN",
        "first_name": "LESLY",
        "credential": "MSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-11-04",
        "last_updated": "2011-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MI",
            "license": "6801089952",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Benton Harbor, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 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.