Active NPI
Rochelle Marsha Broder, PH.D.
- Psychologist
- Huntington Woods, MI
National Provider Identifier
1396910717
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 6301012695
- Practice address
- 10515 Lincoln Dr
Huntington Woods, MI 48070-1542 - Phone
- (248) 227-2568
- Fax
- (248) 399-7356
- NPI assigned
- Apr 26, 2008
- Last updated
- Apr 26, 2008
- 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 |
|---|---|---|---|---|
| Psychologist | 103T00000X | 6301012695 | MI | Primary |
Addresses
Primary practice location
10515 Lincoln Dr
Huntington Woods, MI 48070-1542
Mailing address
10515 Lincoln Dr
Huntington Woods, MI 48070-1542
Phone (248) 227-2568
Medicare participation
Medicare enrollment files- 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
- Opted out of Medicare
- Yes, effective Jul 1, 2019 through Jul 1, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6301012695 | MI | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1209168000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1209168000000",
"number": "1396910717",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10515 LINCOLN DR",
"city": "HUNTINGTON WOODS",
"state": "MI",
"postal_code": "480701542",
"telephone_number": "248-227-2568",
"fax_number": "248-399-7356"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10515 LINCOLN DR",
"city": "HUNTINGTON WOODS",
"state": "MI",
"postal_code": "480701542",
"telephone_number": "248-227-2568",
"fax_number": "248-399-7356"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRODER",
"first_name": "ROCHELLE",
"middle_name": "MARSHA",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-04-26",
"last_updated": "2008-04-26",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "MI",
"license": "6301012695",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Huntington Woods, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2008; 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.