Linda R. Broberg, LMSW

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

073995-1 Issued in NY

Practice address

400 Fort Hill Ave
Canandaigua, NY 14424-1159

Phone

(585) 393-7770

NPI assigned

Nov 27, 2007

Last updated

Nov 27, 2007By 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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1196121600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1196121600000",
    "number": "1235311655",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "73 AUTHORS AVE",
            "city": "HENRIETTA",
            "state": "NY",
            "postal_code": "144679329"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 FORT HILL AVE",
            "city": "CANANDAIGUA",
            "state": "NY",
            "postal_code": "144241159",
            "telephone_number": "585-393-7770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROBERG",
        "first_name": "LINDA",
        "middle_name": "R.",
        "name_prefix": "Ms.",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-11-27",
        "last_updated": "2007-11-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NY",
            "license": "073995-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Mental Health Counselor in Canandaigua, NY
• Providers in Canandaigua, NY by specialty
• Mental Health Counselor in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 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.

Verify at the official NPI Registry.