Laurie Brodeur

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

604 Issued in NH

Practice address

3 12TH St
Berlin, NH 03570-3860

Phone

(603) 752-7404

Fax

(603) 752-5194

NPI assigned

Apr 3, 2007

Last updated

Sep 30, 2026By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NH

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 1990

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Northern Human ServicesGroup PAC ID 3173595931, 27 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Northern Human Services

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Center Conway, NH
  • NPI 1700955028
  Medicare reassignment Care Compare group NPD
• Northern Human Services

  • Mental Health Counselor
  • Conway, NH
  • NPI 1700063617
  NPD (past)

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

{
    "created_epoch": "1175558400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790726400000",
    "number": "1093836009",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "626 EASTMAN RD STE A",
            "city": "CENTER CONWAY",
            "state": "NH",
            "postal_code": "038134219",
            "telephone_number": "603-447-3347",
            "fax_number": "603-447-8893"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 12TH ST",
            "city": "BERLIN",
            "state": "NH",
            "postal_code": "035703860",
            "telephone_number": "603-752-7404",
            "fax_number": "603-752-5194"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRODEUR",
        "first_name": "LAURIE",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-03",
        "last_updated": "2026-09-30",
        "certification_date": "2026-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NH",
            "license": "604",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "225029",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Louise Lillian Boutin, BS
• Mahlon Arthur Bradley, MD
• Miranda Brazier, BA
• Alison Elizabeth Breault, FNP-BC
• Mario Brodeur-Fossa, LICSW
• Daniel George Brofman, WAIVER
• Charles I Brown, M.D.
• Kevin Brungot, WAIVER
• Patricia Lorraine Buckovitch, WAIVER
• Lucille T. Burdick

• Clinical Psychologist in Berlin, NH
• Providers in Berlin, NH by specialty
• Clinical Psychologist in New Hampshire

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.