Ezrikai Broam, LCSW, LADC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

3928 Issued in OK

Practice address

6216 S Lewis Ave Ste 180
Tulsa, OK 74136-1077

Phone

(918) 960-7852

Fax

(539) 664-5738

NPI assigned

Dec 30, 2008

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Lisa Weiche Former name

Medicare fee-for-service enrollment

Enrolled in OK

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

Specialty

Clinical Social Worker

Education

Other, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Improving Lives Counseling Services IncGroup PAC ID 3870818230, 32 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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 and National Provider Directory roles.

• Improving Lives Counseling Services, Inc.

  • Community/Behavioral Health Agency
  • Tulsa, OK
  • NPI 1487967444
  Medicare reassignment Care Compare group NPD
• Indian Health Care Resource Center of Tulsa, Inc.

  • Pharmacy
  • Tulsa, OK
  • NPI 1457447609
  NPD (past)

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

{
    "created_epoch": "1230595200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711411200000",
    "number": "1093951709",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6216 S LEWIS AVE STE 180",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741361077",
            "telephone_number": "918-960-7852",
            "fax_number": "396-645-7385"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6216 S LEWIS AVE STE 180",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741361077",
            "telephone_number": "918-960-7852",
            "fax_number": "539-664-5738"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROAM",
        "first_name": "EZRIKAI",
        "name_prefix": "Ms.",
        "credential": "LCSW, LADC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-12-30",
        "last_updated": "2024-03-26",
        "certification_date": "2024-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OK",
            "license": "1039",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OK",
            "license": "3928",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LISA",
            "last_name": "WEICHE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Kauli Ann Broadhead
• Broadmoor Health Care, LLC (Broadmoor Retirement Community)
• Candis L Broadnax
• Lauren Broadright
• Veneeciea Broadus
• Bridget Anne Brock, MS
• Cynthia Brock, PT
• Kendall Rhys Brock, SLP CF
• Leandra Sue Brock, RN
• Todd Alan Brockman, M.D.

• Clinical Social Worker in Tulsa, OK
• Providers in Tulsa, OK by specialty
• Clinical Social Worker in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2024; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.