Active NPI
Karen K. Broadwell, LMSW
- Clinical Social Worker
- Dallas, TX
National Provider Identifier
1720209570
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 03435
- Practice address
- 4141 Blue Lake Circle
Suite 134
Dallas, TX 75244 - Phone
- (972) 407-6838
- NPI assigned
- May 1, 2007
- 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 |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 03435 | TX | Primary |
Addresses
Primary practice location
4141 Blue Lake Circle
Suite 134
Dallas, TX 75244
Mailing address
3609 Granbury Dr
Dallas, TX 75287-4930
Phone (972) 862-3016
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 |
|---|---|---|---|
| 03435 | TX | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1177977600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1720209570",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3609 GRANBURY DR",
"city": "DALLAS",
"state": "TX",
"postal_code": "752874930",
"telephone_number": "972-862-3016"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4141 BLUE LAKE CIRCLE",
"address_2": "SUITE 134",
"city": "DALLAS",
"state": "TX",
"postal_code": "75244",
"telephone_number": "972-407-6838"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BROADWELL",
"first_name": "KAREN",
"middle_name": "K.",
"name_prefix": "Mrs.",
"credential": "LMSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-05-01",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "TX",
"license": "03435",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Dallas, TX
Sources for this page
- 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.