Elise Bromberg, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

CW012775 Issued in PA

Practice address

329 W Mount Airy Ave
Philadelphia, PA 19119-2941

Phone

(215) 247-6186

NPI assigned

Jun 10, 2007

Last updated

Jul 8, 2007By 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

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Elders Counseling Group

  • Mental Health Counselor
  • Jenkintown, PA
  • NPI 1073545679
  NPD (past)
• Interface Psych Services, Inc

  • Clinical Psychologist
  • Jenkintown, PA
  • NPI 1659569135
  NPD (past)
• Jewish Family & Childrens Serv

  • Community/Behavioral Health Agency
  • Bala Cynwyd, PA
  • NPI 1639231012

  Clinical

  NPD (past)

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

{
    "created_epoch": "1181433600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1578766101",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "329 W MOUNT AIRY AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191192941",
            "telephone_number": "215-247-6186"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "329 W MOUNT AIRY AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191192941",
            "telephone_number": "215-247-6186"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROMBERG",
        "first_name": "ELISE",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-06-10",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "PA",
            "license": "CW012775",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LCSW",
            "identifier": "CW012775",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAGELLAN",
            "identifier": "543509",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lauren Nicole Brogan, DPT
• Pearl Elizabeth Brogdon
• Christopher Brokus
• Bruno Broll-Barone, PH.D.
• Denise M. Broll-Dalton, PA-C
• Michael E Bromberg, MD
• Carlene Bronikowski, D.O.
• Rasheedah Bronson-Hicks
• Robert Bronstein, MD
• Kristina Marie Brook, CRNP

• Clinical Social Worker in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Clinical Social Worker in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.