Shonna Jolene Brodhead, LMSW

Primary specialty

Social WorkerTaxonomy code 104100000X

License

091721-1 Issued in NY

Practice address

Brightpath Counseling
7266 Buckley Road
North Syracuse, NY 13212

Phone

(315) 458-0919

Fax

(315) 458-0594

NPI assigned

Sep 8, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Bright Path Center, Inc.

  • Social Worker
  • North Syracuse, NY
  • NPI 1316046113
  NPD (past)
• Delconte Counseling LCSW PC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • N Syracuse, NY
  • NPI 1427810787

  Social Worker

  NPD (past)

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

{
    "created_epoch": "1504828800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1504828800000",
    "number": "1306364534",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7266 BUCKLEY RD",
            "city": "NORTH SYRACUSE",
            "state": "NY",
            "postal_code": "132122649"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "BRIGHTPATH COUNSELING",
            "address_2": "7266 BUCKLEY ROAD",
            "city": "NORTH SYRACUSE",
            "state": "NY",
            "postal_code": "13212",
            "telephone_number": "315-458-0919",
            "fax_number": "315-458-0594"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRODHEAD",
        "first_name": "SHONNA",
        "middle_name": "JOLENE",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-09-08",
        "last_updated": "2017-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "091721-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "091721-1",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mary Botsford, N.P.
• Sarah Diane Bowers, LCSW-R
• Amy Lynn Branshaw
• David Brennan, DPT
• Bright Path Center, Inc.
• James E Brown Jr., M.D.
• Liane Brown, PT, DPT
• Lisa Anne Brown
• Tanya Leigh Brown, LMSW
• Buckley Road Pediatrics, PLLC

• Social Worker in North Syracuse, NY
• Providers in North Syracuse, NY by specialty
• Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2017; 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.