Rebecca Broaddus, LISW-S, LICDC is a medicare enrolled "Social Worker - Clinical" provider in Shelby, Ohio. Her current practice location is
2775 State Route 39, Shelby, Ohio. You can reach out to her office (for appointments etc.) via phone at
(419) 747-3322.
Rebecca Broaddus is licensed to practice in Ohio (license number I.2203547) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1588190532.
Healthcare Provider's Profile
Full Name | Rebecca Broaddus |
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Gender | Female |
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Speciality | Social Worker - Clinical |
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Location | 2775 State Route 39, Shelby, Ohio |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1588190532
- Provider Enumeration Date: 05/11/2017
- Last Update Date: 11/21/2024
Medicare PECOS Information:
- PECOS PAC ID: 0244617397
- Enrollment ID: I20220511002172
Medical Identifiers
Medical identifiers for Rebecca Broaddus such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1588190532 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
101YA0400X | Counselor - Addiction (substance Use Disorder) | LICDC.162510 (Ohio) | Secondary |
104100000X | Social Worker | S.1502432 (Ohio) | Secondary |
1041C0700X | Social Worker - Clinical | I.2203547 (Ohio) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Rebecca Broaddus allows following entities to bill medicare on her behalf.
Entity Name | Alcove Ventures Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1093191322 PECOS PAC ID: 1456669605 Enrollment ID: O20151007002805 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Rebecca Broaddus is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Rebecca Broaddus, LISW-S, LICDC 2775 State Route 39, Shelby, OH 44875-9466 Ph: (419) 747-3322 | Rebecca Broaddus, LISW-S, LICDC 2775 State Route 39, Shelby, OH 44875-9466 Ph: (419) 747-3322 |
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