Provider Demographics
NPI:1164011946
Name:CLANTON, BRANDI MARIE (LMSW)
Entity Type:Individual
Prefix:
First Name:BRANDI
Middle Name:MARIE
Last Name:CLANTON
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6221 WESTLAKE RD
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:MI
Mailing Address - Zip Code:49021-8233
Mailing Address - Country:US
Mailing Address - Phone:269-364-0663
Mailing Address - Fax:
Practice Address - Street 1:2150 COLUMBIA AVE W
Practice Address - Street 2:
Practice Address - City:BATTLE CREEK
Practice Address - State:MI
Practice Address - Zip Code:49015-2848
Practice Address - Country:US
Practice Address - Phone:269-364-0663
Practice Address - Fax:269-397-2261
Is Sole Proprietor?:No
Enumeration Date:2021-01-15
Last Update Date:2023-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010970881041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical