Active NPI
Samantha Broderick, LGSW, LMSW
- Social Worker
- Washington, DC
National Provider Identifier
1790240307
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- LG50082665
- Practice address
- 1140 3Rd St NE
Washington, DC 20002-6274 - Phone
- (202) 873-9071
- NPI assigned
- Feb 7, 2019
- 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 |
|---|---|---|---|---|
| Social Worker | 104100000X | LG50082665 | DC | Primary |
Addresses
Primary practice location
1140 3Rd St NE
Washington, DC 20002-6274
Mailing address
713 Forston St
Takoma Park, MD 20912-7332
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 |
|---|---|---|---|
| LG50082665 | DC | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1549497600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1549497600000",
"number": "1790240307",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "713 FORSTON ST",
"city": "TAKOMA PARK",
"state": "MD",
"postal_code": "209127332"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1140 3RD ST NE",
"city": "WASHINGTON",
"state": "DC",
"postal_code": "200026274",
"telephone_number": "202-873-9071"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRODERICK",
"first_name": "SAMANTHA",
"credential": "LGSW, LMSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-02-07",
"last_updated": "2019-02-07",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "DC",
"license": "LG50082665",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Washington, DC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.