Provider Demographics
NPI:1154911261
Name:BROUARD, AMY (LMSW, M-CASAC)
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:
Last Name:BROUARD
Suffix:
Gender:F
Credentials:LMSW, M-CASAC
Other - Prefix:
Other - First Name:AMY
Other - Middle Name:
Other - Last Name:PICHARDO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:520 AUDUBON AVE APT 59
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10040-3674
Mailing Address - Country:US
Mailing Address - Phone:917-532-5515
Mailing Address - Fax:
Practice Address - Street 1:493 NOSTRAND AVE STE 3
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11216-5118
Practice Address - Country:US
Practice Address - Phone:917-532-5515
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-22
Last Update Date:2023-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY34822101YA0400X
NYP107502104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)