Marcy Palmer Broder, L.M.S.W.

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

6801018514 Issued in MI

Practice address

4224 Lakeridge Court
Bloomfield Hills, MI 48302-1620

Phone

(248) 626-7171

NPI assigned

Oct 11, 2011

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)

Not enrolled

State licenses

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

{
    "created_epoch": "1318291200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1318291200000",
    "number": "1780969659",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4224 LAKERIDGE COURT",
            "city": "BLOOMFIELD HILLS",
            "state": "MI",
            "postal_code": "483021620",
            "telephone_number": "248-626-7171"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4224 LAKERIDGE COURT",
            "city": "BLOOMFIELD HILLS",
            "state": "MI",
            "postal_code": "483021620",
            "telephone_number": "248-626-7171"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRODER",
        "first_name": "MARCY",
        "middle_name": "PALMER",
        "credential": "L.M.S.W.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-10-11",
        "last_updated": "2011-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801018514",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bright Side Dental Bloomfield Hills
• Bright Side Sleep Solutions, PLLC
• Adam Brode I
• Amy Lynn-Opperer Brode, DO
• Howard S Brode, M.D.
• Sarah R. Brotsky, PSY.D.
• Julie Anne Brouhard, LMSW
• Elexus Beatrice Brown
• Christin Shavon Broyles, CPT
• Bruce H Macpherson MD PC

• Clinical Social Worker in Bloomfield Hills, MI
• Providers in Bloomfield Hills, MI by specialty
• Clinical Social Worker in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2011; 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.