Victoria Jeanne Braddock, LCSW
Individual provider Active NPI Clinical Social Worker · Papillion, NE
NPI 1487273645 · NPPES record last updated Jun 13, 2023
Key facts
- NPI
- 1487273645
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- 103728 (CA)
- Practice address
- 805 S Beadle St
Papillion, NE 68046-2755 - Phone
- (530) 417-7977
- NPI assigned
- Apr 8, 2020
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 4
Medicare Care Compare profile
- Specialty
- Clinical Social Worker
- Education
- Other, 2018
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Alegent Creighton Health
Practice addresses (Care Compare)
801 Harmony St
Suite 302
Council Bluffs, IA 51503-3106
Phone (712) 328-2609
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20250219002514 | IA | Practitioner - Clinical Social Worker | 4981124070 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ASW85165 | CA | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Alegent Creighton Health | Clinical | Current |
Accepting new patients |
| Alegent Creighton Health | Current |
Accepting new patients | |
| Santa Cruz Community Health Centers | Clinical | Past |
Accepting new patients |
Locations
801 Harmony St
Ste 302
Council Bluffs, IA 51503
Phone (712) 328-2609
2771 Solution Ctr
Chicago, IL 60677
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | ASW85165 | CA | |
| Clinical Social Worker | 1041C0700X | 103728 | CA | Yes |
Addresses
Primary practice location
805 S Beadle St
Papillion, NE 68046-2755
Mailing address
805 S Beadle St
Papillion, NE 68046-2755
Phone (530) 417-7977
Other names
- Victoria Jeanne Dzorka
Other providers in Papillion, NE
- Katrina Boyce
- Sydney Boyce
- Karen Ilene Boyd
- Aaron Boykin
- Sarah Boykin
- Stacy Lynn Brant
- Justin Joseph Brazda
- Rachel Breitkreutz
- Melissa D Brestel
- Cheryl L Brewer
All providers in Papillion, NE · Clinical Social Worker in Nebraska
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 13, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.