Active NPI
Safiya Broadwater
- Professional Counselor
- Wyncote, PA
National Provider Identifier
1346110871
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- PC018771
- Practice address
- 7753 Bennett Rd
Wyncote, PA 19095-2301 - Phone
- (267) 473-1034
- NPI assigned
- Nov 10, 2025
- Last updated
- Nov 10, 2025
- 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 |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | PC018771 | PA | Primary |
Addresses
Primary practice location
7753 Bennett Rd
Wyncote, PA 19095-2301
Mailing address
7753 Bennett Rd
Wyncote, PA 19095-2301
Phone (267) 473-1034
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in PA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Mental Health Counselor
- Education
- Other, 2008
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
2507 Philmont Ave
Huntingdon Valley, PA 19006-6229
Phone (732) 814-9428
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PC018771 | PA | MD | Professional Counselor |
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1762732800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1762732800000",
"number": "1346110871",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7753 BENNETT RD",
"city": "WYNCOTE",
"state": "PA",
"postal_code": "190952301",
"telephone_number": "267-473-1034"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7753 BENNETT RD",
"city": "WYNCOTE",
"state": "PA",
"postal_code": "190952301",
"telephone_number": "267-473-1034"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BROADWATER",
"first_name": "SAFIYA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2025-11-10",
"last_updated": "2025-11-10",
"certification_date": "2025-11-10",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "PA",
"license": "PC018771",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Wyncote, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2025; 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.