Elise Broderick Quam, MSW, LICSW
NPI 1891269155ActiveIndividual· Social Worker, Clinical· Eagan, MN
Social Worker, Clinical (MSW, LICSW) with Collaborative Counseling LLC, practicing in Eagan, Minnesota. Enrolled in Medicare as practitioner - clinical social worker.
Overview
| NPI | 1891269155 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | MSW, LICSW |
| Sole proprietor | No |
| NPI issued | Jan 18, 2019 |
| Last updated in NPPES | Jan 18, 2019 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Social Worker, Clinical Primary | 1041C0700X | 25498 | MN |
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 (MN) |
|---|
Education and affiliations
| Graduation year | 2016 |
|---|---|
| Medicare specialty | Clinical Social Worker |
| Telehealth | Offers telehealth |
Medical group
- Collaborative Counseling LLCChanhassen, MN · 41 clinicians
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