Individual provider Active NPI

Brenda K Swan, LMSW

  • Clinical Social Worker
  • Brighton, MI
National Provider Identifier
1851667968
Registry record updated Jan 6, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801083636 Issued in MI
Practice address
12851 Grand River Rd
Brighton, MI 48116-8506
Phone
(810) 225-2501
NPI assigned
Mar 23, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 6, 2016

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 6801083636 MI Primary

Addresses

Primary practice location

12851 Grand River Rd
Brighton, MI 48116-8506

Mailing address

467 Douglas St
Ypsilanti, MI 48197-2024
Phone (734) 417-8663

Other names 1

  • Brenda K Bolzman Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160421001940 MI Practitioner - Clinical Social Worker 9335448539 Practice locations: Ann Arbor, MI

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2002 Hogback Rd
Suite 19
Ann Arbor, MI 48105-9736
Phone (734) 417-8663

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6801083636MIMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1332460800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1452038400000",
    "number": "1851667968",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "467 DOUGLAS ST",
            "city": "YPSILANTI",
            "state": "MI",
            "postal_code": "481972024",
            "telephone_number": "734-417-8663"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12851 GRAND RIVER RD",
            "city": "BRIGHTON",
            "state": "MI",
            "postal_code": "481168506",
            "telephone_number": "810-225-2501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SWAN",
        "first_name": "BRENDA",
        "middle_name": "K",
        "credential": "LMSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-03-23",
        "last_updated": "2016-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801083636",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BRENDA",
            "last_name": "BOLZMAN",
            "middle_name": "K",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Brighton, MI

Sources for this page

Verify at the official NPI Registry.