Active NPI
Katherine Brodsky, MSW, LICSW
- Mental Health Counselor
- Manchester, NH
National Provider Identifier
1306995006
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 132
- Practice address
- 66 Prospect St
Manchester, NH 03104-3506 - Phone
- (603) 668-1975
- Fax
- (603) 666-0804
- NPI assigned
- Jan 10, 2007
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 132 | NH | Primary |
Addresses
Primary practice location
66 Prospect St
Manchester, NH 03104-3506
Mailing address
66 Prospect St
Manchester, NH 03104-3506
Phone (603) 668-1975
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| EDS2254899 | Medicaid | NH |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 132 | NH | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1168387200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1306995006",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "66 PROSPECT ST",
"city": "MANCHESTER",
"state": "NH",
"postal_code": "031043506",
"telephone_number": "603-668-1975",
"fax_number": "603-666-0804"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "66 PROSPECT ST",
"city": "MANCHESTER",
"state": "NH",
"postal_code": "031043506",
"telephone_number": "603-668-1975",
"fax_number": "603-666-0804"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRODSKY",
"first_name": "KATHERINE",
"credential": "MSW, LICSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-01-10",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "NH",
"license": "132",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "EDS2254899",
"state": "NH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Manchester, NH
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.