MRS. SUSAN BERNICE BRODERICK (NPI# 1073002556) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1073002556 |
| Entity Type | Individual |
| Full Name | MRS. SUSAN BERNICE BRODERICK |
| Credential | LCSW |
| Practice Address |
40w222 Lafox Rd Ste P2b St Charles IL 60175-7625 |
| Mailing Address |
11925 Ellwood Greens Rd Genoa IL 60135-8142 |
| Practice Telephone | 8157516884 |
| Mailing Telephone | 8157516884 |
| Enumeration Date | 2018-05-09 |
| Last Update Date | 2018-05-09 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1041C0700X |
Social Worker Specialization: Clinical |
149012332 | IL | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750504890 | Susan Clare Broderick | Audiologist | 11973 Camp Eden Rd, Golden, CO 80403-8606 | 2007-04-10 |
| 1669784401 | Susan H Broderick | Physical Therapist | 590 Middlebury Rd, Suite A, Middlebury, CT 06762-2562 | 2010-07-09 |
| 1326184417 | Susan S Broderick | Social Worker | 4400 Breckenridge Ln, 1st Floor, Louisville, KY 40218-4082 | 2007-01-29 |
| Street Address |
40W222 LAFOX RD STE P2B |
| City | ST CHARLES |
| State | IL |
| Zip Code | 60175-7625 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740733138 | Ryan Paul Kuebler | Dentist | 40w320 La Fox Rd., Suite D, St Charles, IL 60175 | 2016-08-02 |
| 1346602554 | Erica Witkowski | Specialist/Technologist | 6n 370 Crescent Lane, Saint Charles, IL 60175 | 2016-03-26 |
| 1437495728 | Bradley S Murison | Physical Therapist | 3381 W State St., Suite 100, St Charles, IL 60175 | 2012-12-14 |
| 1942507355 | Fox River & Countryside Fire/rescue District | Ambulance | 35w350 Carl Lee Road, St Charles, IL 60175 | 2011-02-21 |
| 1871825984 | Fay E Jackson | Counselor | 3140 W Route 64, St. Charles, IL 60175 | 2010-02-01 |
| 1801126941 | Philip James Kocisko | Counselor | 3140 W. Route 64, Saint Charles, IL 60175 | 2010-01-13 |
| 1891971529 | Caroline M Bollentino | Speech-Language Pathologist | 40w310 La Fox Rd, Suite A1-b1, St Charles, IL 60175 | 2008-01-11 |
| 1770783599 | Joy O Urubusi | Psychiatry & Neurology | 3825 Campton Hills Road, St Charles, IL 60175 | 2007-07-19 |
| 1225236052 | Anna Almase Medina | Dentist | 2445 Dean, 1c, St Charles, IL 60175 | 2007-07-03 |
| 1467666453 | Shelly Sinatra | Nurse Practitioner | 3310 W. Main St, Suite 200, St. Charles, IL 60175 | 2007-05-09 |
| Find all providers in zip 60175 | ||||
| Taxonomy Code | 1041C0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Social Worker |
| Specialization | Clinical |
| A social worker who holds a master’s or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master’s supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances. |
| Notes: Source: National Association of Social Workers, 2008 [7/1/2009: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023634490 | Stephanie Clorinda Stavropoulos | Social Worker | 3103 Easton Pl, St Charles, IL 60175-5610 | 2020-06-22 |
| 1407481963 | Amber L Kay | Social Worker | 1118 E Main St # 2a, St Charles, IL 60174-2260 | 2020-03-05 |
| 1245874205 | Addaline Johannah Stoll | Social Worker | 1815 Oak St, St Charles, IL 60174-3634 | 2019-11-03 |
| 1497399943 | Tiffany M Kasper | Social Worker | 2560 Foxfield Rd Ste 320, St Charles, IL 60174-5731 | 2019-10-28 |
| 1134775885 | Nancy R Krtek, Lcsw, Counseling and Consultation Pllc | Social Worker | 473 Dunham Rd Ste 216, St Charles, IL 60174-1423 | 2019-08-16 |
| 1164074118 | Kimberly Berry | Social Worker | 103 N 11th Ave Ste 239, St Charles, IL 60174-2289 | 2019-07-10 |
| 1760907109 | Celina Wollak | Social Worker | 1539 Independence Ave, St Charles, IL 60174-4461 | 2017-08-07 |
| 1013455385 | Jennifer Blandford | Social Worker | 303 N 2nd St Ste 21, Suite 21, St Charles, IL 60174-1804 | 2017-02-07 |
| 1760856819 | Heather O'hara | Social Worker | 34w948 Stanton Dr, St Charles, IL 60174-6784 | 2015-11-29 |
| 1619374733 | Patricia Lingo | Social Worker | 311 S 4th Ave, St Charles, IL 60174-2915 | 2014-12-04 |
| Find all providers in ST CHARLES | ||||
| City | ST CHARLES |
| Zip Code | 60175 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.