Rebecca Broaddus, LISW-S, LICDC
NPI 1588190532ActiveIndividual· Social Worker, Clinical· Shelby, OH
Social Worker, Clinical (LISW-S, LICDC) in Shelby, Ohio, licensed in OH, with an NPI issued in May 2017. Enrolled in Medicare as practitioner - clinical social worker.
Overview
| NPI | 1588190532 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | LISW-S, LICDC |
| Sole proprietor | Yes |
| NPI issued | May 11, 2017 |
| Last updated in NPPES | Nov 21, 2024 |
| Certified by provider | Nov 21, 2024 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Social Worker, Clinical Primary | 1041C0700X | I.2203547 | OH |
| Counselor, Addiction (Substance Use Disorder) | 101YA0400X | LICDC.162510 | OH |
| Social Worker | 104100000X | S.1502432 | OH |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - Clinical Social Worker (OH) |
|---|
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