NICOLE BROUSSARD (LCSW) – Clinical Social Worker, NPI 1023572526

NICOLE BROUSSARD (LCSW) is a healthcare provider. based in Houston, Texas. specializing in Clinical Social Worker. They hold the professional credentials LCSW. They hold a License No. 59567 (TX). The NPI Number for NICOLE BROUSSARD (LCSW) is 1023572526

Main info

Female
20 Years Of Experience
Accepts Medicare Assignment
Name
NICOLE BROUSSARD (LCSW)
NPI
1023572526
Phone
(832) 824-7012
Address
6651 MAIN ST.
Enumeration Date
29 January 2019
Last Update Date
12 July 2019

Doctor Profile

Medical School Name
OTHER
Secondary Phone
8328241000
Graduation Year
2006 (20 years ago)
PAC ID
3678812922
Group Practice PAC ID
4385722081
Professional Enrollment ID
I20190304001279
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience28
Completeness75
Years active:7State licenses:1Digital endpointsOther names

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Provider Addresses for NICOLE BROUSSARD (LCSW)

  • Pavilion for Women, 6651, Main Street, Texas Medical Center, Houston, Harris County, Texas, 77030, United States

    MC E. 1920

    HOUSTON, TX 77030

    Phone: (832) 824-7012

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2019-03-04

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20190304001279IClinical Social WorkerTXTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 77030)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 4385722081View full group profile
NameSpecialtyState
Pediatric MedicineTX
Pediatric Medicine, Allergy/ImmunologyTX
Pediatric Medicine, Pulmonary DiseaseTX
Physician AssistantTX
Orthopedic SurgeryTX
-TX
U R O L O G YAR
-TX
N E P H R O L O G YTX
Pediatric Medicine, Critical Care (Intensivists)TX

Reviews

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Frequently asked questions

Can I verify NICOLE BROUSSARD (LCSW) with an NPI only?
You can start verification with NPI 1023572526 for NICOLE BROUSSARD (LCSW), then check state licensing separately.
Can I rely on NICOLE BROUSSARD (LCSW) being an active provider?
As of the registry snapshot, NICOLE BROUSSARD (LCSW) is marked active.
What is NICOLE BROUSSARD (LCSW)'s primary classification?
Clinical Social Worker is the headline specialty for NICOLE BROUSSARD (LCSW) here. Clinical services aligned with this taxonomy classification.
Where is NICOLE BROUSSARD (LCSW) based?
NICOLE BROUSSARD (LCSW) is tied to Houston, Texas in the data we show; additional addresses may exist on the full record.
Why does NICOLE BROUSSARD (LCSW) have multiple addresses?
2 practice locations appear in the available data. Multiple addresses are common for hospital privileges, telehealth, or multi-site groups.

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