Lola Madrone Broomberg, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

C3168 Issued in OR

Practice address

541 Willamette St Ste 207a
Eugene, OR 97401-2623

Phone

(541) 686-8119

Fax

(541) 686-3340

NPI assigned

Jul 18, 2013

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OR

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

Mental Health Counselor

Education

Other, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1374105600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1556064000000",
    "number": "1336581404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "541 WILLAMETTE ST STE 102",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974012687",
            "telephone_number": "541-341-3477"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "541 WILLAMETTE ST STE 207A",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974012623",
            "telephone_number": "541-686-8119",
            "fax_number": "541-686-3340"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROOMBERG",
        "first_name": "LOLA",
        "middle_name": "MADRONE",
        "name_prefix": "Ms.",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-07-18",
        "last_updated": "2019-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "OR",
            "license": "C3168",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OR",
            "license": "C3168",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OR",
            "license": "C3168",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500692264",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Holly Brooks, LMT
• Kaitlyn Brooks, PTA
• Rebekah Jane Brooks, LCSW
• Stephanie Lynn Brooks, A.T.C.
• Zachary Brooks, DPM
• Rosalie Broomfield, LCSW
• Stefanie Brosemer, CADCII CRM QMHA
• Kymberlea Kirstin Broten, BS
• Donald Ray Brothers III, PSS, BA, THW
• Kendra Alison Brott, MAT, MS

• Professional Counselor in Eugene, OR
• Providers in Eugene, OR by specialty
• Professional Counselor in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2019; 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.