Nicole Justine Brogdon, MAC LPC LMFT

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

63068 Issued in TX

Practice address

2720 Bee Caves Rd
Austin, TX 78746-5642

Phone

(512) 217-5247

Fax

(512) 732-0556

NPI assigned

Mar 3, 2017

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1488499200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1488499200000",
    "number": "1003356577",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2720 BEE CAVES RD",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787465642",
            "telephone_number": "512-217-5247",
            "fax_number": "512-732-0556"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2720 BEE CAVES RD",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787465642",
            "telephone_number": "512-217-5247",
            "fax_number": "512-732-0556"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROGDON",
        "first_name": "NICOLE",
        "middle_name": "JUSTINE",
        "credential": "MAC LPC LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-03-03",
        "last_updated": "2017-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "63068",
            "primary": true
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "TX",
            "license": "201143",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brittany Brodeur
• Harris Elliot Brodsky, M.D.
• Sarah Broekhoven, MS, RDN, LDN
• Lisa Karen Brogan, FNP-C
• Philip Brogden, LMT
• Broken Halo Counseling Center, PLLC
• Mandis Terrazas Broker, M.S., CCC-SLP
• Leslie Edward Broline, DDS MS
• Caroline Smith Broll, MA, LPC
• Courtney Bromberek, CGC

• Professional Counselor in Austin, TX
• Providers in Austin, TX by specialty
• Professional Counselor in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.