Individual provider Active NPI

Karen Langfur Broussard, LCSW

  • Clinical Social Worker
  • Winter Park, FL
National Provider Identifier
1023287513
Registry record updated Feb 28, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SW5732 Issued in FL
Practice address
2100 Lee Rd
Winter Park, FL 32789-1862
Phone
(407) 644-7593
Fax
(407) 628-0773
NPI assigned
Feb 28, 2008
Last updated
Feb 28, 2008By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 28, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X SW5732 FL Primary

Addresses

Primary practice location

2100 Lee Rd
Winter Park, FL 32789-1862

Mailing address

2100 Lee Rd
Winter Park, FL 32789-1862
Phone (407) 644-7593

Other identifiers 1

IdentifierTypeStateIssuer
E5271ZOtherFLMEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
SW5732FLMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Jewish Family Services of Greater Orlando Inc PastSince Jun 8, 2016 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1204156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1204156800000",
    "number": "1023287513",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 LEE RD",
            "city": "WINTER PARK",
            "state": "FL",
            "postal_code": "327891862",
            "telephone_number": "407-644-7593",
            "fax_number": "407-628-0773"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 LEE RD",
            "city": "WINTER PARK",
            "state": "FL",
            "postal_code": "327891862",
            "telephone_number": "407-644-7593",
            "fax_number": "407-628-0773"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROUSSARD",
        "first_name": "KAREN",
        "middle_name": "LANGFUR",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-02-28",
        "last_updated": "2008-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW5732",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "E5271Z",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Winter Park, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.