Taylor Marie Broermann
Individual provider Active NPI Social Worker · Eaton, OH
NPI 1285309518 · NPPES record last updated Aug 10, 2021
Key facts
- NPI
- 1285309518
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Social Worker 104100000X
- License
- S.2106673 (OH)
- Practice address
- 204 N Barron St Ste B
Eaton, OH 45320-1765 - Phone
- (937) 456-2805
- NPI assigned
- Aug 10, 2021
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| S.2106673 | OH | MD | Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Gebhart Counseling Solutions, LLC | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | S.2106673 | OH | Yes |
Addresses
Primary practice location
204 N Barron St Ste B
Eaton, OH 45320-1765
Mailing address
204 N Barron St Ste B
Eaton, OH 45320-1765
Phone (937) 456-2805
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | Computer |
Other providers in Eaton, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 10, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.