Organization Active NPI

Brosh Inc

  • Clinical Social Worker
  • Fort Wayne, IN
National Provider Identifier
1164060653
Registry record updated Dec 15, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
BROSH INC
Practice address
4820 Oak Knob Run
Fort Wayne, IN 46845-8939
Phone
(260) 249-5432
NPI assigned
Dec 15, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 15, 2019

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

Authorized official

Name
Bree Ricker, MSW, LCSWNPI 1508175274
Title
Licensed Clinical Social Worker
Phone
(260) 249-5432

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X Primary

Addresses

Primary practice location

4820 Oak Knob Run
Fort Wayne, IN 46845-8939

Mailing address

4820 Oak Knob Run
Fort Wayne, IN 46845-8939

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1576368000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1576368000000",
    "number": "1164060653",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4820 OAK KNOB RUN",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468458939"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4820 OAK KNOB RUN",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468458939",
            "telephone_number": "260-249-5432"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BROSH INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-12-15",
        "last_updated": "2019-12-15",
        "certification_date": "2019-12-15",
        "status": "A",
        "authorized_official_last_name": "RICKER",
        "authorized_official_first_name": "BREE",
        "authorized_official_title_or_position": "LICENSED CLINICAL SOCIAL WORKER",
        "authorized_official_telephone_number": "260-249-5432",
        "authorized_official_credential": "MSW, LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Wayne, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2019; 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.