Mary Ellen Brogan, MSW, LSW

Primary specialty

Social WorkerTaxonomy code 104100000X

License

SW126825 Issued in PA

Practice address

150 Greyhorse Rd
Willow Grove, PA 19090-1607

Phone

(203) 249-7664

NPI assigned

Mar 8, 2011

Reactivated

Oct 10, 2019

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

Electronic endpoints 1

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": "1299542400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571788800000",
    "number": "1891093324",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 GREYHORSE RD",
            "city": "WILLOW GROVE",
            "state": "PA",
            "postal_code": "190901607",
            "telephone_number": "203-249-7664"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 GREYHORSE RD",
            "city": "WILLOW GROVE",
            "state": "PA",
            "postal_code": "190901607",
            "telephone_number": "203-249-7664"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROGAN",
        "first_name": "MARY ELLEN",
        "credential": "MSW, LSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-03-08",
        "last_updated": "2019-10-23",
        "deactivation_date": "2015-10-07",
        "reactivation_date": "2019-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "PA",
            "license": "SW126825",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "WillowGrove",
            "affiliation": "N",
            "address_1": "150 Greyhorse Rd",
            "city": "Willow Grove",
            "state": "PA",
            "country_code": "US",
            "postal_code": "190901607",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Elizabeth Braccia-Hubbard, LCSW
• Shyam Brahmabhatt, MD
• Raymond Braunstein, PH.D.
• Kathryn Bringhurst
• Janine Rose Brodovsky
• Laura Brovender-Fisher, PT,CHT
• Najah I Brown, MED, BCBA
• Marisa Elizabeth Browne, RDN
• Tommy Richard Buchanan Jr., M.D.
• Nancy Janice Buonpastore, CRNA

• Social Worker in Willow Grove, PA
• Providers in Willow Grove, PA by specialty
• Social Worker in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 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.

Verify at the official NPI Registry.