Active NPI
Carol Ann Broda, MED LPC
- Professional Counselor
- Pompton Lakes, NJ
National Provider Identifier
1164577177
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 37PC00337800
- Practice address
- 105 Hamburg Turnpike
Pompton Lakes, NJ 07442 - Phone
- (973) 831-0613
- Fax
- (973) 831-0957
- NPI assigned
- Jan 23, 2007
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 37PC00337800 | NJ | Primary |
Addresses
Primary practice location
105 Hamburg Turnpike
Pompton Lakes, NJ 07442
Mailing address
21 Evans Place
C/O New Bridge Services Inc
Pompton Plains, NJ 07444
Phone (973) 907-2700
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
- Master of Education
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 37PC00337800 | NJ | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Newbridge Services, Inc. | Past | Accepting new patients | |
| Newbridge Services, Inc. | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
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- Mental Health Clinic/Center (Including Community Mental Health Center)
- Parsippany, NJ
- NPI 1982768420
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1169510400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1164577177",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "21 EVANS PLACE",
"address_2": "C/O NEW BRIDGE SERVICES INC",
"city": "POMPTON PLAINS",
"state": "NJ",
"postal_code": "07444",
"telephone_number": "973-907-2700",
"fax_number": "973-839-4770"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "105 HAMBURG TURNPIKE",
"city": "POMPTON LAKES",
"state": "NJ",
"postal_code": "07442",
"telephone_number": "973-831-0613",
"fax_number": "973-831-0957"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRODA",
"first_name": "CAROL",
"middle_name": "ANN",
"name_prefix": "Ms.",
"credential": "MED LPC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-01-23",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "NJ",
"license": "37PC00337800",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Pompton Lakes, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.