Brent Thomas Dudley, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

SW16576 Issued in FL

Practice address

16531 NW 18TH Ave
Opa Locka, FL 33054-6617

Phone

(786) 985-3618

NPI assigned

May 9, 2020

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)

Enrolled

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

{
    "created_epoch": "1588982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1589241600000",
    "number": "1912529256",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21211 NW 32ND AVE",
            "city": "MIAMI GARDENS",
            "state": "FL",
            "postal_code": "330561151",
            "telephone_number": "786-985-3618"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16531 NW 18TH AVE",
            "city": "OPA LOCKA",
            "state": "FL",
            "postal_code": "330546617",
            "telephone_number": "786-985-3618"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUDLEY",
        "first_name": "BRENT",
        "middle_name": "THOMAS",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-05-09",
        "last_updated": "2020-05-12",
        "certification_date": "2020-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW16576",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Janys Diaz Infante
• Yanelis Diaz Rodriguez, RBT
• Jeniffer Diaz
• Yaniris Dieppa Montes de Oca
• DNR Medical, Inc
• Sargine Dupuy, M.D.
• Elegant Beauty Supplies # 9 Inc
• Elite-R-US LLC
• Seth Ellis Sr., RDN
• Empowering Minds, Inc

• Clinical Social Worker in Opa Locka, FL
• Providers in Opa Locka, FL by specialty
• Clinical Social Worker in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2020; 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.