Traci R Ballou-Broadnax, PSYD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

0810007624 Issued in VA

Practice address

312 Neff Ave
Harrisonburg, VA 22801-3429

Phone

(540) 433-2858

Fax

(540) 433-1175

NPI assigned

Oct 4, 2021

Last updated

Oct 4, 2021By 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

Enrolled in VA

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, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mountain View Psychology LLCGroup PAC ID 5890949580, 4 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Mountain View Psychology, LLC

  • Clinical Psychologist
  • Harrisonburg, VA
  • NPI 1962746370
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1633305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633305600000",
    "number": "1235801614",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "312 NEFF AVE",
            "city": "HARRISONBURG",
            "state": "VA",
            "postal_code": "228013429",
            "telephone_number": "540-433-2858",
            "fax_number": "540-433-1175"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "312 NEFF AVE",
            "city": "HARRISONBURG",
            "state": "VA",
            "postal_code": "228013429",
            "telephone_number": "540-433-2858",
            "fax_number": "540-433-1175"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BALLOU-BROADNAX",
        "first_name": "TRACI",
        "middle_name": "R",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-10-04",
        "last_updated": "2021-10-04",
        "certification_date": "2021-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "VA",
            "license": "0810007624",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Morgan Renee Baker, ATC
• Carolann Baldridge
• Anna Maria Balfour
• Tara Douglas Balint, MD
• Amanda Renee Ball
• Lisa K Bandur, D.C
• Nancy Bansal Agrawal
• Jean-Marie Prestwidge Barch, PH.D.
• Emma Izamar Barker, PA-C
• Renetta Barksdale

• Clinical Psychologist in Harrisonburg, VA
• Providers in Harrisonburg, VA by specialty
• Clinical Psychologist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2021; 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.