Jinny Renee Broderick, LCSW
NPI 1558441717ActiveIndividual· Social Worker, Clinical· Fort Wayne, IN
Social Worker, Clinical (LCSW) with Park Center Inc, practicing in Fort Wayne, Indiana. Enrolled in Medicare as practitioner - clinical social worker.
Overview
| NPI | 1558441717 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | LCSW |
| Sole proprietor | No |
| NPI issued | Oct 16, 2006 |
| Last updated in NPPES | Sep 29, 2010 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Social Worker, Clinical Primary | 1041C0700X | 34005183A | IN |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - Clinical Social Worker (IN) |
|---|
Education and affiliations
| Graduation year | 2002 |
|---|---|
| Medicare specialty | Clinical Social Worker |
Medical group
- Park Center IncFort Wayne, IN · 46 clinicians
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