Active NPI
Stephanie Broadgate, LMFT
- Marriage & Family Therapist
- Methow, WA
National Provider Identifier
1003214016
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- LF61399760
- Practice address
- 24 Main Street
Methow, WA 98834 - Phone
- (206) 456-6229
- NPI assigned
- Dec 8, 2014
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | LF61399760 | WA | Primary |
Addresses
Primary practice location
24 Main Street
Methow, WA 98834
Mailing address
PO Box 718
Methow, WA 98834-0718
Phone (206) 456-6229
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LF61399760 | WA | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1417996800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1689811200000",
"number": "1003214016",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 718",
"city": "METHOW",
"state": "WA",
"postal_code": "988340718",
"telephone_number": "206-456-6229"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "24 MAIN STREET",
"city": "METHOW",
"state": "WA",
"postal_code": "98834",
"telephone_number": "206-456-6229"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BROADGATE",
"first_name": "STEPHANIE",
"credential": "LMFT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-12-08",
"last_updated": "2023-07-20",
"certification_date": "2023-07-17",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "WA",
"license": "LF61399760",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Methow, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.