Brenda Church
Individual provider Active NPI Social Worker · Bad Axe, MI
NPI 1942639729 · NPPES record last updated Nov 2, 2013
Key facts
- NPI
- 1942639729
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Social Worker 104100000X
- License
- 6802059332 (MI)
- Practice address
- 1108 S Van Dyke Rd
Bad Axe, MI 48413-9615 - Phone
- (989) 269-9293
- NPI assigned
- Nov 2, 2013
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6802059332 | MI | MD | Social Worker |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 6802059332 | MI | Yes |
Addresses
Primary practice location
1108 S Van Dyke Rd
Bad Axe, MI 48413-9615
Mailing address
1108 S Van Dyke Rd
Bad Axe, MI 48413-9615
Phone (989) 269-9293
Other providers in Bad Axe, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 2, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.