Ms Laura A Broderick, LCSW is a
Social Worker - Clinical based in Hines, Illinois. Ms Laura A Broderick is licensed to practice in Illinois (license number 149007636) and her current practice location is
5000 S 5th Ave, Hines, Illinois. She can be reached at her office (for appointments etc.) via phone at
(708) 202-8387.
NPI number for Ms Laura A Broderick is 1396069100 and her current mailing address is 5000 S 5th Ave, Hines, Illinois. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1396069100.
Healthcare Provider's Profile
| Full Name | Ms Laura A Broderick |
|---|
| Gender | Female |
|---|
| Speciality | Social Worker - Clinical |
|---|
| Location | 5000 S 5th Ave, Hines, Illinois |
|---|
| Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
|---|
NPI Data:
- NPI Number: 1396069100
- Provider Enumeration Date: 03/23/2010
- Last Update Date: 11/20/2012
Medical Identifiers
Medical identifiers for Ms Laura A Broderick such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1396069100 | NPI | - | NPPES |
| 149007636 | Medicaid | IL | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | (NU) | Secondary |
| 101YM0800X | Counselor - Mental Health | (NU) | Secondary |
| 1041C0700X | Social Worker - Clinical | 149007636 (Illinois) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Ms Laura A Broderick is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Ms Laura A Broderick, LCSW
5000 S 5th Ave,
Hines, IL 60141-3030
Ph: (708) 202-8387 | Ms Laura A Broderick, LCSW
5000 S 5th Ave,
Hines, IL 60141-3030
Ph: (708) 202-8387 |
Reviews and Comments