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THERESA A BROCKMAN LISW
NPI 1346618063
Social Worker in Lebanon, OH

Active since September 11, 2015PECOS Enrolled
1231 COLUMBUS AVE UNIT A1, LEBANON, OH 45036(513) 695-4495(513) 228-1236 Get Directions Write a Review

NPPES record last updated: November 19, 2021. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Nov 19, 2021, Aug 18, 2021, Apr 1, 2021 and 1 more (4 updates tracked since 2020).

About Theresa A Brockman Lisw NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

THERESA A BROCKMAN LISW (NPI 1346618063) is an individual social worker in Lebanon, Ohio, licensed in Ohio (I1451226) and active in the NPI registry since September 2015. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1346618063
Entity TypeIndividualFemale
Primary Taxonomy104100000X
Provider Legal NameTHERESA A BROCKMANCredential: LISW
Location Address1231 COLUMBUS AVE UNIT A1Lebanon, OH 45036-8196
Mailing Address424 Wards Corner Rd Ste 200Loveland, OH 45140-6966 · (513) 576-7700 · Fax (513) 576-1020
Phone(513) 695-4495
Fax(513) 228-1236
Sole ProprietorNo
Enumeration DateSeptember 11, 2015
Last NPPES UpdateNovember 19, 20214 updates tracked since enumeration
NPPES CertifiedNovember 19, 2021
✔ NPI 1346618063 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySocial WorkerBehavioral Health & Social Service Providers
Taxonomy Code104100000X
License✔ Licensed in OH · I1451226
Definition
A social worker is a person who is qualified by a Social Work degree, and licensed, certified or registered by the state as a social worker to practice within the scope of that license. A social worker provides assistance and counseling to clients and their families who are dealing with social, emotional and environmental problems. Social work services may be rendered to individuals, families, groups, and the public.
1231 COLUMBUS AVE UNIT A1, Lebanon, OH 45036
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Other Identifiers 1

Medicaid0165638OH

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter from Meridian, Ambetter Health and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Theresa A Brockman Lisw is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Theresa Brockman reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Healthsource Of Ohio, Inc.
0.2 mi
Clinic/Center
1231 COLUMBUS AVE, UNIT A 1
Lebanon, OH 45036
  • Reassigned Medicare billing, Ohio enrollment
  • 79 clinicians in this Medicare group
NPI 1407288210 (513) 696-4495

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Other Providers at the Same Location NPPES 4

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MARIANNE ELIZABETH CHERNESKY MD
Family Medicine
1231 COLUMBUS AVE UNIT A1
LEBANON, OH 45036
Warren County (513) 695-4495
TIFFANY CRIDER
Family Medicine
1231 COLUMBUS AVE UNIT A1
LEBANON, OH 45036
Warren County (513) 695-4495
DR. MARY ELIZABETH KREBS M.D.
Family Medicine
1231 COLUMBUS AVE UNIT A1
LEBANON, OH 45036
Warren County (513) 696-4495
MATHEW WHEELER
Nurse Practitioner
1231 COLUMBUS AVE UNIT A1
LEBANON, OH 45036
Warren County (513) 696-4495

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Theresa Brockman's NPI number?

The NPI number for Theresa Brockman is 1346618063. It was assigned to this individual provider in the NPPES registry on September 11, 2015.

Where is Theresa Brockman located?

Theresa Brockman practices at 1231 Columbus Ave Unit A1, Lebanon, OH 45036. The listed phone number is (513) 695-4495.

What is Theresa Brockman's specialty?

The primary specialty registered for this NPI is Social Worker with taxonomy code 104100000X.

Is Theresa Brockman enrolled in Medicare?

Yes. Theresa Brockman is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Theresa Brockman's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Theresa Brockman reassigns Medicare benefits to Healthsource Of Ohio, Inc. (Lebanon, OH). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Theresa Brockman's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Theresa Brockman accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Meridian, Anthem Blue Cross and Blue Shield and CareSource and 5 other insurers list Theresa Brockman as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Theresa Brockman was last updated on November 19, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.