Active NPI
Andrea Marie Brodhuber, LMSW
- Social Worker
- Smithtown, NY
National Provider Identifier
1366173486
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 101426
- Practice address
- 285 E Main St Ste LL5
Smithtown, NY 11787-2980 - Phone
- (631) 724-0600
- Fax
- (631) 724-0606
- NPI assigned
- Jun 20, 2022
- Sex
- Female
- 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 | 101426 | NY | Primary |
Addresses
Primary practice location
285 E Main St Ste LL5
Smithtown, NY 11787-2980
Mailing address
8 Keystone CT
Centereach, NY 11720-2882
Phone (631) 413-1208
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 101426 | NY | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1655683200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1655683200000",
"number": "1366173486",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8 KEYSTONE CT",
"city": "CENTEREACH",
"state": "NY",
"postal_code": "117202882",
"telephone_number": "631-413-1208"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "285 E MAIN ST STE LL5",
"city": "SMITHTOWN",
"state": "NY",
"postal_code": "117872980",
"telephone_number": "631-724-0600",
"fax_number": "631-724-0606"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRODHUBER",
"first_name": "ANDREA",
"middle_name": "MARIE",
"name_prefix": "Mrs.",
"credential": "LMSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-06-20",
"last_updated": "2022-06-20",
"certification_date": "2022-06-16",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Social Worker",
"state": "NY",
"license": "101426",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Smithtown, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.