Individual provider Active NPI

Tamara Jennifer Brown, LMSW, LCSW

  • Clinical Social Worker
  • Wyoming, MI
National Provider Identifier
1861950404
Registry record updated Mar 2, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801095947 Issued in MI
Practice address
2663 44TH St SW Ste 106
Wyoming, MI 49519-4189
Phone
(616) 414-0123
NPI assigned
Mar 2, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 2, 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 53404 TX
Clinical Social Worker 1041C0700X 6801095947 MI Primary

Addresses

Primary practice location

2663 44TH St SW Ste 106
Wyoming, MI 49519-4189

Mailing address

3626 Cobblefield Cir SE Apt 9
Caledonia, MI 49316-7667
Phone (210) 215-1665

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
I20190813000313 MI Practitioner - Clinical Social Worker 4688901762 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Portal Point Counseling LLCGroup PAC ID 5698002418, 3 clinicians

Practice addresses (Care Compare)

1428 44TH St SW
Suite B
Wyoming, MI 49509-4312
Phone (616) 279-1551

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
53404TXMDPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1551484800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1551484800000",
    "number": "1861950404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3626 COBBLEFIELD CIR SE APT 9",
            "city": "CALEDONIA",
            "state": "MI",
            "postal_code": "493167667",
            "telephone_number": "210-215-1665"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2663 44TH ST SW STE 106",
            "city": "WYOMING",
            "state": "MI",
            "postal_code": "495194189",
            "telephone_number": "616-414-0123"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN",
        "first_name": "TAMARA",
        "middle_name": "JENNIFER",
        "credential": "LMSW, LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-03-02",
        "last_updated": "2019-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "53404",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801095947",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wyoming, MI

Sources for this page

Verify at the official NPI Registry.