Debra A Broughman, LMSW, CAADC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

6801087888 Issued in MI

Practice address

1530 Nichols Rd
Kalamazoo, MI 49006-2065

Phone

(269) 343-6700

NPI assigned

Feb 27, 2007

Last updated

Sep 21, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MI

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

Specialty

Clinical Social Worker

Education

Other, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Pine Rest Christian Mental Health ServicesGroup PAC ID 4981506508, 354 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Pine Rest Christian Mental Health Services

  • Social Worker
  • Grand Rapids, MI
  • NPI 1922019157
  Medicare reassignment Care Compare group NPD
• Willow Path Counseling Services

  • Community/Behavioral Health Agency
  • Kalamazoo, MI
  • NPI 1568997054
  Medicare reassignment
• Pine Rest Christian Mental Health Services

  • Professional Counselor
  • Grand Rapids, MI
  • NPI 1386015683
  NPD
• Community Mental Health Services of St Joseph County

  dba Community Mental Health and Substance Abuse Services of St Joseph Coun

  • Community/Behavioral Health Agency
  • Centreville, MI
  • NPI 1366438483
  NPD (past)

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

{
    "created_epoch": "1172534400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600646400000",
    "number": "1831226216",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 68TH ST SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495486927",
            "telephone_number": "269-273-5000",
            "fax_number": "269-273-8019"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1530 NICHOLS RD",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490062065",
            "telephone_number": "269-343-6700"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "300 68th St SE",
            "address_purpose": "LOCATION",
            "city": "Grand Rapids",
            "state": "MI",
            "postal_code": "495486927",
            "country_code": "US",
            "telephone_number": "800-678-5500",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "210 S Main Street",
            "address_purpose": "LOCATION",
            "city": "Three Rivers",
            "state": "MI",
            "postal_code": "49093",
            "country_code": "US",
            "telephone_number": "269-273-5000",
            "fax_number": "269-273-8019",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BROUGHMAN",
        "first_name": "DEBRA",
        "middle_name": "A",
        "name_prefix": "Ms.",
        "credential": "LMSW, CAADC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-27",
        "last_updated": "2020-09-21",
        "certification_date": "2020-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801087888",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1708146",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kelle Lyn Brooks, LMSW
• Leatrice Renee Brooks, PH.D.
• Nire Brooks
• William Douglas Brooks, ED.D.
• Brookside Care LLC
• Sade Broussard
• Mason Brouwer
• Benjamin R Brower
• Leah Brower, MA, CCC-SLP
• Alan E. Brown, LMSW, LMFT

• Clinical Social Worker in Kalamazoo, MI
• Providers in Kalamazoo, 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 Sep 21, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.