Active NPI
Mackenzie Bedor, LLMSW
- Social Worker
- Pontiac, MI
National Provider Identifier
1881189918
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 6801102645
- Practice address
- 1701 Baldwin Ave
Pontiac, MI 48340-3412 - Phone
- (248) 334-4962
- NPI assigned
- Jul 1, 2018
- Last updated
- Jul 1, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 6801102645 | MI | Primary |
Addresses
Primary practice location
1701 Baldwin Ave
Pontiac, MI 48340-3412
Mailing address
8047 Bridge Lake Rd
Clarkston, MI 48348-4146
Phone (248) 804-6357
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6801102645 | MI | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1530403200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1530403200000",
"number": "1881189918",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8047 BRIDGE LAKE RD",
"city": "CLARKSTON",
"state": "MI",
"postal_code": "483484146",
"telephone_number": "248-804-6357"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1701 BALDWIN AVE",
"city": "PONTIAC",
"state": "MI",
"postal_code": "483403412",
"telephone_number": "248-334-4962"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BEDOR",
"first_name": "MACKENZIE",
"credential": "LLMSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-07-01",
"last_updated": "2018-07-01",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "MI",
"license": "6801102645",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Pontiac, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.