Active NPI
Jean Broussard
- Social Worker
- Fort Collins, CO
National Provider Identifier
1184559593
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- Practice address
- 3003 E Harmony Rd Ste 120
Fort Collins, CO 80528-9625 - Phone
- (970) 214-0610
- NPI assigned
- Jun 16, 2026
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | Primary |
Addresses
Primary practice location
3003 E Harmony Rd Ste 120
Fort Collins, CO 80528-9625
Mailing address
2845 Golden Wheat LN
Fort Collins, CO 80528-3128
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1781568000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1781568000000",
"number": "1184559593",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2845 GOLDEN WHEAT LN",
"city": "FORT COLLINS",
"state": "CO",
"postal_code": "805283128"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3003 E HARMONY RD STE 120",
"city": "FORT COLLINS",
"state": "CO",
"postal_code": "805289625",
"telephone_number": "970-214-0610"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BROUSSARD",
"first_name": "JEAN",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2026-06-16",
"last_updated": "2026-06-16",
"certification_date": "2026-06-16",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Social Worker",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Fort Collins, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.