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Individual
MS. SHEILA EILEEN BRODERICK
Active
Individual
MS. SHEILA EILEEN BRODERICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
C000912
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
130YH
BCBS PROVIDER NUMBER
NC
01
—
318282
MHN PROVIDER NUMBER
NC
01
—
343264
MAMSI PROVIDER NUMBER
NC
01
—
456981000
MAGELLAN PROVIDER NUMBER
NC
05
—
6002361
—
NC
01
—
651197169
UBH PROVIDER NUMBER
NC
Enumeration date
09/25/2006
Last updated
11/29/2021
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