Active NPI
Jodie E Broman, BA, CAAR, CDPT
- Mental Health Counselor
- Olympia, WA
National Provider Identifier
1083143556
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 60456236
- Practice address
- 3857 Martin Way E
Olympia, WA 98506-5268 - Phone
- (360) 704-7170
- NPI assigned
- Jun 8, 2017
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 60459915 | WA | |
| Mental Health Counselor | 101YM0800X | 60456236 | WA | Primary |
Addresses
Primary practice location
3857 Martin Way E
Olympia, WA 98506-5268
Mailing address
3857 Martin Way E
Olympia, WA 98506-5268
Phone (360) 704-7170
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100554 | Medicaid | WA |
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
- Credentials
- Bachelor of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 60459915 | WA | MD | Addiction (Substance Use Disorder) Counselor |
| 60456236 | WA | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1496880000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1496880000000",
"number": "1083143556",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3857 MARTIN WAY E",
"city": "OLYMPIA",
"state": "WA",
"postal_code": "985065268",
"telephone_number": "360-704-7170"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3857 MARTIN WAY E",
"city": "OLYMPIA",
"state": "WA",
"postal_code": "985065268",
"telephone_number": "360-704-7170"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BROMAN",
"first_name": "JODIE",
"middle_name": "E",
"name_prefix": "Ms.",
"credential": "BA, CAAR, CDPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-06-08",
"last_updated": "2017-06-08",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "WA",
"license": "60459915",
"primary": false
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "WA",
"license": "60456236",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100554",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Olympia, WA
- Kenneth J. Brock
- Jonathan D Brockman-Hawe
- Jennifer Brocx, LMT
- Genna Brodsky Chase, LICSW
- Janet Brodsky, LICSW
- Mark Joseph Bronk, MARK BRONK, LMP
- Brookdale Senior Living Communities, Inc. (Clare Bridge of Olympia)
- Brooks Blessings Home Care LLC (FirstLight Home Care - South Sound)
- Dave Brooks, LMP
- Denise Marie Brooks, LPN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 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.