Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Mr. Tyler A Broadwell, LICSW

Individual provider Clinical Social Worker · NPI 1770307001

Mr. Tyler A Broadwell, LICSW is a Clinical Social Worker in Minneapolis, Minnesota. Qualified in 2020, 6 years ago. Practices with Hennepin Healthcare System Inc, a 903-clinician group and accepts Medicare assignment. Licensed in Minnesota.

Years since qualifying
6
Licensed in
MN
In the registry since
2024
What do these letters mean?
LICSW — Licensed Independent Clinical Social Worker
The title some states use for an independently practising clinical social worker.

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Practice location Address checks out

701 Park Ave
Minneapolis, MN 55415-1623
Phone: (612) 873-3000
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X · Licence 29018 (MN)

Record details

NPI number1770307001
Entity typeIndividual (Type 1)
GenderMale
Credentials LICSW
Sole proprietorNo
NPI enumeratedNovember 13, 2024
Last updated in NPPESSeptember 9, 2025
Certification dateSeptember 9, 2025

Medicare enrollment

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

Medicare specialtyCLINICAL SOCIAL WORKER
Medical schoolOTHER
Graduated 2020 (6 years in practice)
Group practice Hennepin Healthcare System Inc — 903 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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