Individual provider · Type 1 NPI

Shannon Broderick, LSCSW

Clinical Social Worker · Wichita, KS

NPI number 1386096790 Active

Practice location

801 E Douglas Ave Fl 2
Wichita, KS 67202-3548

Call (646) 941-7645 Map

Fax (929) 596-7897

Specialties and licenses

TaxonomyCodeLicense
Social Worker 104100000X10002 (KS)
Social Worker 104100000X2016027520 (MO)
Clinical Social Worker Primary 1041C0700X07235 (KS)

Clinical Social Worker: A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpers…

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About NPI 1386096790

Shannon Broderick, LSCSW's National Provider Identifier is 1386096790, issued on Jul 9, 2016. The primary taxonomy on file is Clinical Social Worker (1041C0700X), and the practice location is in Wichita, KS. The record was last updated on Jun 16, 2026.