Individual provider Active NPI

Brittany Brdicko, LISW, LCSW

  • Social Worker
  • North Liberty, IA
National Provider Identifier
1770197436
Registry record updated Sep 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
086139 Issued in IA
Practice address
1290 Jordan St
North Liberty, IA 52317-8020
Phone
(319) 463-3308
Fax
(319) 358-2367
NPI assigned
Sep 1, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 28, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X SW20208 FL
Social Worker 104100000X 086139 IA Primary

Addresses

Primary practice location

1290 Jordan St
North Liberty, IA 52317-8020

Mailing address

1290 Jordan St
North Liberty, IA 52317-8020
Phone (319) 463-3308

Other practice location 1

1026 A Ave NE
Cedar Rapids, IA 52402-5036
Phone (319) 368-5913

Other practice location 2

722 Trade Way
Sanford, FL 32771
Phone (407) 863-4001

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230502001070 IA Practitioner - Clinical Social Worker 2860877628 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Psychiatric Associates of Iowa, PCGroup PAC ID 9638550544, 50 clinicians

Practice addresses (Care Compare)

1290 Jordan St
North Liberty, IA 52317-8020
Phone (319) 432-0531

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SW20208FLMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Psychiatric Associates of Iowa, PC CurrentSince Jun 5, 2023 Accepting new patients
Psychiatric Associates of Iowa, PC CurrentSince Jun 5, 2023 Accepting new patients
Todd Verhoef, MD P.C. Past Accepting new patients

Locations

3900 Fountains Blvd NE
Ste 203
Cedar Rapids, IA 52411
Phone (319) 727-8297

673 Westbury Dr
Ste 201
Iowa City, IA 52245
Phone (319) 356-6352

2545 N Dodge St
Ste C
Iowa City, IA 52245
Phone (319) 249-0307

1290 Jordan St
North Liberty, IA 52317
Phone (319) 356-6352

1900 Silver Lake Rd NW
Saint Paul, MN 55112
Phone (651) 379-1704

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1598918400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695859200000",
    "number": "1770197436",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1290 JORDAN ST",
            "city": "NORTH LIBERTY",
            "state": "IA",
            "postal_code": "523178020",
            "telephone_number": "319-463-3308",
            "fax_number": "319-358-2367"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1290 JORDAN ST",
            "city": "NORTH LIBERTY",
            "state": "IA",
            "postal_code": "523178020",
            "telephone_number": "319-463-3308",
            "fax_number": "319-358-2367"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1026 A Ave NE",
            "address_purpose": "LOCATION",
            "city": "Cedar Rapids",
            "state": "IA",
            "postal_code": "524025036",
            "country_code": "US",
            "telephone_number": "319-368-5913",
            "fax_number": "319-369-7812",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "722 Trade Way",
            "address_purpose": "LOCATION",
            "city": "Sanford",
            "state": "FL",
            "postal_code": "32771",
            "country_code": "US",
            "telephone_number": "407-863-4001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BRDICKO",
        "first_name": "BRITTANY",
        "name_prefix": "Mrs.",
        "credential": "LISW, LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-09-01",
        "last_updated": "2023-09-28",
        "certification_date": "2022-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW20208",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "IA",
            "license": "086139",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Liberty, IA

Sources for this page

Verify at the official NPI Registry.