Mary Ellen Broughton, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

R0259181 Issued in NY

Practice address

243 Main St
Suite 203
New Paltz, NY 12561-1325

Phone

(845) 255-8323

Fax

(845) 255-5832

NPI assigned

Jan 11, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Emmy Broughton Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1168473600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1281916800000",
    "number": "1013067180",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 357",
            "city": "GARDINER",
            "state": "NY",
            "postal_code": "12525",
            "telephone_number": "845-255-8323"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "243 MAIN ST",
            "address_2": "SUITE 203",
            "city": "NEW PALTZ",
            "state": "NY",
            "postal_code": "125611325",
            "telephone_number": "845-255-8323",
            "fax_number": "845-255-5832"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROUGHTON",
        "first_name": "MARY",
        "middle_name": "ELLEN",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-11",
        "last_updated": "2010-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "R0259181",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHI",
            "identifier": "GHI 7400885",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "EMMY",
            "last_name": "BROUGHTON",
            "credential": "LCSW",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Carolyn Rounds Boris, LCSW-R
• James S Bove, MD
• Wendy Kaye Bower, SLP
• Leonore Briones
• Roxanne Brognano
• Madison S Brower
• Carolyn Brown, L.AC.
• Olivia Profaci Brown
• Ellen M Brunning, MS,ED.
• Donna M Bruschi, IBCLC

• Clinical Social Worker in New Paltz, NY
• Providers in New Paltz, NY by specialty
• Clinical Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2010; 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.