Individual provider Active NPI

Joseph Edward Broome, MA, LMHC, CMHS, EMHS

  • Mental Health Counselor
  • Renton, WA
National Provider Identifier
1114150307
Registry record updated Jun 4, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
LH 60200686 Issued in WA
Practice address
306 Wells Ave S Unit a
Renton, WA 98057
Phone
(206) 295-0624
Fax
(888) 274-5277
NPI assigned
Sep 3, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 4, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X LH 60200686 WA Primary

Addresses

Primary practice location

306 Wells Ave S Unit a
Renton, WA 98057

Mailing address

306 Wells Ave S Unit a
Renton, WA 98057-2786
Phone (206) 295-0624

Other practice location 1

310 Wells Ave S
Ste. 306D
Renton, WA 98057-2714
Phone (206) 295-0624

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Sep 26, 2024 through Sep 26, 2026

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
LH 60200686WAMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1251936000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1559606400000",
    "number": "1114150307",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "306 WELLS AVE S UNIT A",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "980572786",
            "telephone_number": "206-295-0624",
            "fax_number": "888-274-5277"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "306 WELLS AVE S UNIT A",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "98057",
            "telephone_number": "206-295-0624",
            "fax_number": "888-274-5277"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "310 Wells Ave S",
            "address_2": "Ste. 306D",
            "address_purpose": "LOCATION",
            "city": "Renton",
            "state": "WA",
            "postal_code": "980572714",
            "country_code": "US",
            "telephone_number": "206-295-0624",
            "fax_number": "888-274-5277",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BROOME",
        "first_name": "JOSEPH",
        "middle_name": "EDWARD",
        "name_prefix": "Mr.",
        "credential": "MA, LMHC, CMHS, EMHS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-09-03",
        "last_updated": "2019-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WA",
            "license": "LH 60200686",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Renton, WA

Sources for this page

Verify at the official NPI Registry.