MEDICARE: MRS. BRANDELINE R BROWN-LOBATO MSW, LCSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	5750	OK
2	1041C0700X	Clinical Social Worker	6801119479	MI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	5750	OTHER	OK	LICENSED CLINICAL SOCIAL WORKER LICENSE
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1447520879
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. BRANDELINE R BROWN-LOBATO MSW, LCSW

Provider Business Mailing Address
First Line	:	28475 GREENFIELD RD STE 113
Second Line	:
City	:	SOUTHFIELD
State	:	MI
Zip	:	48076-3034
Country	:	US
Telephone Number	:	248-607-0887
Fax Number	:

Provider Business Practice Location Address
First Line	:	28475 GREENFIELD RD STE 113
Second Line	:
City	:	SOUTHFIELD
State	:	MI
Zip	:	48076-3034
Country	:	US
Telephone Number	:	248-607-0887
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/02/2012
Last Update Date	:	04/18/2025

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