Adriana Elizabeth Broglie, LPC

Key facts

NPI

1356980288

Entity type

Individual (NPI type 1)

Primary specialty

Professional Counselor 101YP2500X

License

PC011895 (PA)

Practice address

920 E Baltimore Pike Ste 200
Kennett Square, PA 19348-1800

Phone

(610) 388-9225

Fax

(484) 770-9290

NPI assigned

Dec 23, 2019

Sex

Female

Sole proprietor

No

Medicare participation

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)

Yes

State licenses

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Dec 23, 2019.

{
    "created_epoch": "1577059200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1577059200000",
    "number": "1356980288",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "520 PORT ROYAL CT",
            "city": "LANDENBERG",
            "state": "PA",
            "postal_code": "193501333",
            "telephone_number": "302-547-6098"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "920 E BALTIMORE PIKE STE 200",
            "city": "KENNETT SQUARE",
            "state": "PA",
            "postal_code": "193481800",
            "telephone_number": "610-388-9225",
            "fax_number": "484-770-9290"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROGLIE",
        "first_name": "ADRIANA",
        "middle_name": "ELIZABETH",
        "name_prefix": "Ms.",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-12-23",
        "last_updated": "2019-12-23",
        "certification_date": "2019-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "PA",
            "license": "PC011895",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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