Individual provider Active NPI

Heather Marie Broussard, LCSW

  • Clinical Social Worker
  • Houston, TX
National Provider Identifier
1134815269
Registry record updated May 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
56876 Issued in TX
Practice address
1941 East Rd
Houston, TX 77054-6010
Phone
(713) 486-2700
Fax
(713) 486-2721
NPI assigned
Apr 12, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 17, 2024

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 56876 TX Primary

Addresses

Primary practice location

1941 East Rd
Houston, TX 77054-6010

Mailing address

7373 Ardmore St Apt 1129
Houston, TX 77054-4214
Phone (337) 519-3946

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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

Enrollment IDStateProvider typePAC IDDetails
I20240614001715 TX Practitioner - Clinical Social Worker 4880137181 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Ut PhysiciansGroup PAC ID 8426960360, 1,744 clinicians

Practice addresses (Care Compare)

1941 E Rd
Houston, TX 77054-6010

6410 Fannin St
Houston, TX 77030-3005

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
56876TXMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Ut Physicians CurrentSince Jun 24, 2024 Accepting new patients
Ut Physicians CurrentSince Jun 24, 2024 Accepting new patients

Locations

6410 Fannin St
Ste 500
Houston, TX 77030
Phone (713) 500-5714

1941 East Rd
Houston, TX 77054
Phone (713) 486-2500

6410 Fannin St
#135
Houston, TX 77030

2002 Holcombe Blvd
Va Hospital, TX 77030
Phone (713) 794-1414

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1681257600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715904000000",
    "number": "1134815269",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7373 ARDMORE ST APT 1129",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770544214",
            "telephone_number": "337-519-3946"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1941 EAST RD",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770546010",
            "telephone_number": "713-486-2700",
            "fax_number": "713-486-2721"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROUSSARD",
        "first_name": "HEATHER",
        "middle_name": "MARIE",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-04-12",
        "last_updated": "2024-05-17",
        "certification_date": "2024-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "56876",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.