Diane Dillard Broadnax, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LC301533 Issued in DC

Practice address

2570 Sherman Ave NW
Washington, DC 20001-2299

Phone

(202) 232-6100

Fax

(202) 483-4560

NPI assigned

Jan 6, 2009

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

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 and National Provider Directory roles.

• District Healthcare Services, LLC

  • Community/Behavioral Health Agency
  • Washington, DC
  • NPI 1366939225
  NPD (past)

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

{
    "created_epoch": "1231200000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1231200000000",
    "number": "1649416033",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13256 MANOR TER",
            "city": "MOUNT AIRY",
            "state": "MD",
            "postal_code": "217713952",
            "telephone_number": "301-829-3371",
            "fax_number": "301-829-3391"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2570 SHERMAN AVE NW",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200012299",
            "telephone_number": "202-232-6100",
            "fax_number": "202-483-4560"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROADNAX",
        "first_name": "DIANE",
        "middle_name": "DILLARD",
        "name_prefix": "Mrs.",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-01-06",
        "last_updated": "2009-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "DC",
            "license": "LC301533",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Geoffrey Paul Broadbent, MD
• Rosanna Broadbent, RN
• Savannah A Broadbooks
• Marsha Renee Broadie
• Barry Broadnax Jr.
• Jonathan Broadnax
• Michelle Aleta Broadnax, M.D.
• Rashan J'Mal Broadnax
• Tarin Broadnax
• Talia Broadus, PA-C

• Clinical Social Worker in Washington, DC
• Providers in Washington, DC by specialty
• Clinical Social Worker in District of Columbia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2009; 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.