KELLY ANNE BRODERICK (NPI# 1407193758) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1407193758 |
| Entity Type | Individual |
| Full Name | KELLY ANNE BRODERICK |
| Credential | LICSW |
| Practice Address |
152 Lynnway Ste 2c Lynn MA 01902-3420 |
| Mailing Address |
811 Polo Rd Apt 235 Columbia SC 29223-4425 |
| Practice Telephone | 6179823996 |
| Mailing Telephone | 2076713599 |
| Enumeration Date | 2013-01-07 |
| Last Update Date | 2020-05-28 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1041C0700X |
Social Worker Specialization: Clinical |
122657 | MA | Behavioral Health & Social Service Providers |
| N | 171M00000X | Case Manager/Care Coordinator | Other Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881817443 | Kelly R. Broderick | Counselor | 515 S Ashland Ave, La Grange, IL 60525-2812 | 2007-04-11 |
| 1609821891 | Kelly Clark Broderick | Radiology | 100 S San Mateo Dr, San Mateo, CA 94401-3805 | 2006-05-24 |
| Street Address |
152 LYNNWAY STE 2C |
| City | LYNN |
| State | MA |
| Zip Code | 01902-3420 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922190628 | Jeannette L. Coleman | Social Worker | 152 Lynnway Ste 2c, Lynn, MA 01902-3420 | 2006-09-29 |
| 1376032623 | Aeon Nonprofit Training Associates, LLC | Clinic/Center | 152 Lynnway Ste 2c, Lynn, MA 01902-3420 | 2018-05-02 |
| 1346523099 | Andrew Velasquez | Social Worker | 152 Lynnway Ste 2c, Lynn, MA 01902-3420 | 2011-09-20 |
| 1093964892 | Christopher Carlson | Social Worker | 152 Lynnway Ste 2c, Lynn, MA 01902 | 2008-09-17 |
| 1962684258 | Elizabeth Jean Hortie | Social Worker | 152 Lynnway Ste 2c, Lynn, MA 01902-3420 | 2007-11-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093291130 | Top Care Physical Therapy Rehab | Clinic/Center | 373 Chatham St # 2, Lynn, MA 01902 | 2018-07-12 |
| 1407343726 | Patricia De Leon | Developmental Therapist | 176 Franklin St., Lynn, MA 01902 | 2018-04-23 |
| 1578076725 | Janice S. Baltoumas | Dietitian, Registered | Element Care Inc., 37 Friend Street, Lynn, MA 01902 | 2017-11-09 |
| 1396263174 | Jayna Kathryn Doherty-kinloch | Social Worker | 31 Clark Street, Lynn, MA 01902 | 2017-08-31 |
| 1891219416 | Omobolanle O. Akinyemi | Licensed Practical Nurse | 9 Buffum St, Element Care Inc, Lynn, MA 01902 | 2017-07-26 |
| 1003330523 | Jessica Lee Crowley | Registered Nurse | 9 Buffum St., Element Care Inc, Lynn, MA 01902 | 2017-07-26 |
| 1689198228 | Shannon Gomatos | Registered Nurse | 20 School St., Lynn, MA 01902 | 2017-07-26 |
| 1578087193 | Josephine P. Cooke | Registered Nurse | 62 Market St., Element Care Inc, Lynn, MA 01902 | 2017-07-26 |
| 1316471568 | Ujunwa Okwukaogu | Registered Nurse | 118 Franklin Street #3, Lynn, MA 01902 | 2017-04-14 |
| 1033655501 | Francis Howard Crowley | Social Worker | 37 Friend Street, Element Care, Lynn, MA 01902 | 2017-01-09 |
| Find all providers in zip 01902 | ||||
| Taxonomy Code | 1041C0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Social Worker |
| Specialization | Clinical |
| A social worker who holds a master’s or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master’s supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances. |
| Notes: Source: National Association of Social Workers, 2008 [7/1/2009: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114558400 | Elyssa Diamond | Social Worker | 8 Woodlawn St, Lynn, MA 01904-2844 | 2020-01-27 |
| 1811462641 | Mindy R Celona | Social Worker | 139 Woodlawn St, Lynn, MA 01904-2845 | 2018-10-08 |
| 1710452883 | Dianne Kuzia Hills | Social Worker | 98 Willow St, Lynn, MA 01901-1109 | 2018-10-04 |
| 1417432345 | Brittany L Cunningham | Social Worker | 500 Lynnfield St Unit East3, Lynn, MA 01904-1424 | 2018-09-26 |
| 1093294845 | Tina Hoofnagle | Social Worker | 100 Bennett Street, Lynn, MA 01905 | 2018-08-13 |
| 1528546991 | Dorothy Perry | Social Worker | Bayridge Hospital 60 Granite St, Lynn, MA 01904 | 2018-07-30 |
| 1841790862 | Mckenzie Ferguson | Social Worker | 330 Lynnway Ste 201, Lynn, MA 01901-1713 | 2018-02-16 |
| 1396253688 | Pamela Fineman Maltz | Social Worker | 33 N Common St, Lynn, MA 01902-4311 | 2018-01-20 |
| 1831613199 | Marie Linda Yannaco-grant | Social Worker | 62 Market Street, Lynn, MA 01901 | 2017-07-28 |
| 1033655501 | Francis Howard Crowley | Social Worker | 37 Friend Street, Element Care, Lynn, MA 01902 | 2017-01-09 |
| Find all providers in LYNN | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.