Broadside Psychotherapy

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

BROADSIDE PSYCHOTHERAPY

Practice address

16610 N Suncrest Dr
Nine Mile Falls, WA 99026-9476

Phone

(267) 969-0447

NPI assigned

Jul 24, 2026

Organization subpart

No

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

Authorized official

Name

Miss Isabel Taccheri, LICSW

Title

Owner

Phone

(267) 969-0447

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1784851200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1784851200000",
    "number": "1003737941",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1818 W FRANCIS AVE # 180",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992056834",
            "telephone_number": "267-969-0447"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16610 N SUNCREST DR",
            "city": "NINE MILE FALLS",
            "state": "WA",
            "postal_code": "990269476",
            "telephone_number": "267-969-0447"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BROADSIDE PSYCHOTHERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-07-24",
        "last_updated": "2026-07-24",
        "certification_date": "2026-07-24",
        "status": "A",
        "authorized_official_last_name": "TACCHERI",
        "authorized_official_first_name": "ISABEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "267-969-0447",
        "authorized_official_name_prefix": "Miss",
        "authorized_official_credential": "LICSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer Lynn Anderson, RN
• Lance William Barnes, OD
• Brianne Renae Baughn, LICSW
• Kelsey Beaton, LMT
• Natalie Gayle Berry, OTR/L
• Lucinda Louise Collins, RN
• Mindy Crane
• Custom Nurse Delegation, LLC
• Matthew Peter Dinsmore, ARNP
• Cyrus San Nicolas Dolph, L.M.P.

• Clinical Social Worker in Nine Mile Falls, WA
• Providers in Nine Mile Falls, WA by specialty
• Clinical Social Worker in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2026; 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.