Maggie Hood Bromberg, PHD

Primary specialty

Clinical Child & Adolescent PsychologistTaxonomy code 103TC2200X

License

PY60470885 Issued in WA

Practice address

1307 N 45TH St Ste 200
Seattle, WA 98103-6741

Phone

(253) 271-4059

NPI assigned

Jun 5, 2017

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Dec 14, 2020 through Dec 14, 2026

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Child and Adolescent Psychological Services of Seattle, PLLC

  • Adolescent and Children Mental Health Clinic/Center
  • Seattle, WA
  • NPI 1093473704
  NPD

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

{
    "created_epoch": "1496620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1496620800000",
    "number": "1376072371",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1545 NW MARKET ST APT 520",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981075256"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1307 N 45TH ST STE 200",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981036741",
            "telephone_number": "253-271-4059"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROMBERG",
        "first_name": "MAGGIE",
        "middle_name": "HOOD",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-06-05",
        "last_updated": "2017-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "WA",
            "license": "PY60470885",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Susan Marie Brogger
• Gabrielle Brokaw-Lien
• Corbin James Brokaw, PA-C
• Wolfgang Brolley, PT
• Jacquelyn Kay Brolsma, ARNP
• Leon Bromley, ARNP
• Olivia Bromley
• Meghan Bronkema, PMHNP-BC
• Aaron Bronow
• Jacob J Bronowski, LMP

• Clinical Child & Adolescent Psychologist in Seattle, WA
• Providers in Seattle, WA by specialty
• Clinical Child & Adolescent Psychologist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2017; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.