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Contact Information

LAURA A BRODERICK, L.C.S.W
5000 S 5TH AVE
HINES, IL60141-3030
 Phone: 708-202-8387
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Clinical

1041C0700X 80 Licensed Clinical Social Worker
 

Addiction (Substance Use Disorder)

101YA0400X
 

Mental Health

101YM0800X
Indicates primary specialty

NPI Profile & details for LAURA A BRODERICK · (Female)

NPI # 1396069100
Status Active
Credentials L.C.S.W
Entity Individual
Enumeration date 03/23/2010
Last updated 11/20/2012 - About 14 years ago
Sole proprietor 1 No
Identifiers
  • IL License # 149007636
  • IL Medicaid 149007636
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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