Emily Broom, MA

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

L4624 Issued in OR

Practice address

435 NE Evans St Ste a
McMinnville, OR 97128-4635

Phone

(503) 472-4020

Fax

(503) 472-8630

NPI assigned

Aug 14, 2014

Last updated

Aug 30, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OR

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts

Practice roles

Locations

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.

• Lutheran Community Services Northwest

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Portland, OR
  • NPI 1326056433
  Medicare reassignment NPD
• Lutheran Community Services Northwest

  dba Lcsnw

  • Community/Behavioral Health Agency
  • McMinnville, OR
  • NPI 1255542106
  NPD
• Lutheran Community Services Northwest

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Klamath Falls, OR
  • NPI 1720105489
  NPD (past)

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

{
    "created_epoch": "1407974400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661817600000",
    "number": "1063811073",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "435 NE EVANS ST STE A",
            "city": "MCMINNVILLE",
            "state": "OR",
            "postal_code": "971284635",
            "telephone_number": "503-472-4020",
            "fax_number": "503-472-8630"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "435 NE EVANS ST STE A",
            "city": "MCMINNVILLE",
            "state": "OR",
            "postal_code": "971284635",
            "telephone_number": "503-472-4020",
            "fax_number": "503-472-8630"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROOM",
        "first_name": "EMILY",
        "credential": "MA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-08-14",
        "last_updated": "2022-08-30",
        "certification_date": "2022-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OR",
            "license": "L4624",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brookdale Senior Living Communities, Inc. (Brookdale McMinnville Town Center)
• Brookdale Senior Living Communities, Inc. (Brookdale McMinnville Westside)
• Brookdale Senior Living Communities, Inc. (Wynwood of McMinnville)
• Karen Brooks
• Kevin Brooks
• Leslie M. Brott, M.D.
• Thomas David Brouddus
• Benjamin Brown, MSW
• Jana Brown
• Lori A Brown, ABO/NCLE

• Clinical Social Worker in McMinnville, OR
• Providers in McMinnville, OR by specialty
• Clinical Social Worker in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.