Rebecca Broaddus, LISW-S, LICDC

NPI #1588190532 in Shelby, Ohio

Provider Information

NPI Number: 1588190532
Entity Type: Individual
Name: Rebecca Broaddus, LISW-S, LICDC
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Social Worker - Clinical
Credential: LISW-S, LICDC
Enumeration Date: May 11, 2017
Last Updated: Nov 21, 2024

Practice Location

Address: 2775 STATE ROUTE 39
City: Shelby
State: Ohio
ZIP Code: 44875-9466
Phone: (419) 747-3322

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Counselor - Addiction (Substance Use Disorder) — Addiction (Substance Use Disorder)	101YA0400X
Social Worker	104100000X
Social Worker - Clinical — Clinical	1041C0700X	Primary

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