Risa Eve Broudy, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

0810003440 Issued in VA

Practice address

1655 Fort Myer Dr Ste 820
Arlington, VA 22209-3106

Phone

(703) 965-7477

NPI assigned

Apr 11, 2007

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1176249600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1524009600000",
    "number": "1336363647",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5711 4TH ST N",
            "city": "ARLINGTON",
            "state": "VA",
            "postal_code": "222051003",
            "telephone_number": "703-351-1036"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1655 FORT MYER DR STE 820",
            "city": "ARLINGTON",
            "state": "VA",
            "postal_code": "222093106",
            "telephone_number": "703-965-7477"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROUDY",
        "first_name": "RISA",
        "middle_name": "EVE",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-11",
        "last_updated": "2018-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "DC",
            "license": "PSY1000254",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "VA",
            "license": "0810003440",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ann K Brokaw, CRNP
• Amy Kristine Bronick, FNP
• Brooke'S Home Healthcare Services LLC
• Alfred Bennette Brooks, M.D.
• Natalie Brooks
• Brian Brouillette, PHARMD
• Lindsay Brow, SPT
• Nicholas Brow
• Abigail Ann Brown, PHD
• Brian K Brown

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2018; 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.