Dylan Rose Broggio, LCSW-R, ACSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

076603-1 Issued in NY

Practice address

1416 Sweet Home Rd
Suite 8
Amherst, NY 14228-2784

Phone

(734) 474-6987

NPI assigned

Aug 4, 2006

Last updated

Jul 2, 2010By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Nov 7, 2024 through Nov 7, 2026

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1154649600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1278028800000",
    "number": "1346258522",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "87 LAKE LEDGE DR",
            "city": "WILLIAMSVILLE",
            "state": "NY",
            "postal_code": "142215751",
            "telephone_number": "734-474-6987"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1416 SWEET HOME RD",
            "address_2": "SUITE 8",
            "city": "AMHERST",
            "state": "NY",
            "postal_code": "142282784",
            "telephone_number": "734-474-6987"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROGGIO",
        "first_name": "DYLAN",
        "middle_name": "ROSE",
        "name_prefix": "Ms.",
        "credential": "LCSW-R, ACSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-04",
        "last_updated": "2010-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "076603-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Social Worker in Amherst, NY
• Providers in Amherst, NY by specialty
• Clinical Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.