Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Brad Deroma

Individual provider Addiction (Substance Use Disorder) Counselor · NPI 1902579998

Brad Deroma is a Clinical Social Worker in Phoenix, Arizona. Qualified in 2021, 5 years ago. Accepts Medicare assignment. Licensed in Arizona.

Years since qualifying
5
Licensed in
AZ
In the registry since
2021
Specialties on file
2
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Practice location Address checks out

15815 S Lakewood Pkwy W Apt 2016
Phoenix, AZ 85048-7291
Phone: (760) 613-6861
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Addiction (Substance Use Disorder) Counselor (primary) Taxonomy 101YA0400X · Licence LIAC-155343 (AZ)
Addiction (Substance Use Disorder) Counselor Taxonomy 101YA0400X

Record details

NPI number1902579998
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedJuly 27, 2021
Last updated in NPPESOctober 23, 2024
Certification dateOctober 23, 2024
Mailing address15815 S Lakewood Pkwy W Apt 2119, Phoenix, AZ 85048-7294

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCLINICAL SOCIAL WORKER
Medical schoolOTHER
Graduated 2021 (5 years in practice)
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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