Active NPI
Richard Allen Broome, BS LAC
- Counselor
- Indianapolis, IN
National Provider Identifier
1154037000
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- License
- 86000289A
- Practice address
- 8202 Clearvista Pkwy Ste D
Indianapolis, IN 46256-1400 - Phone
- (317) 623-3007
- NPI assigned
- Jan 24, 2023
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | 86000289A | IN | Primary |
Addresses
Primary practice location
8202 Clearvista Pkwy Ste D
Indianapolis, IN 46256-1400
Mailing address
155 Franklin Rd Ste 430
Brentwood, TN 37027-1602
Phone (615) 751-0579
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 Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 86000289A | IN | MD | Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1674518400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1674518400000",
"number": "1154037000",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "155 FRANKLIN RD STE 430",
"city": "BRENTWOOD",
"state": "TN",
"postal_code": "370271602",
"telephone_number": "615-751-0579"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8202 CLEARVISTA PKWY STE D",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462561400",
"telephone_number": "317-623-3007"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BROOME",
"first_name": "RICHARD",
"middle_name": "ALLEN",
"name_prefix": "Mr.",
"credential": "BS LAC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2023-01-24",
"last_updated": "2023-01-24",
"certification_date": "2023-01-24",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "IN",
"license": "86000289A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Indianapolis, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.