Anna Rene Broussard

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

LPC-12927 Issued in AZ

Practice address

6625 S Rural Rd
Suite 111
Tempe, AZ 85283-3717

Phone

(480) 751-1020

NPI assigned

Apr 2, 2008

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Rene Broussard Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1207094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1207094400000",
    "number": "1427220144",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 24242",
            "city": "TEMPE",
            "state": "AZ",
            "postal_code": "85283",
            "telephone_number": "480-444-9075",
            "fax_number": "480-751-1020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6625 S RURAL RD",
            "address_2": "SUITE 111",
            "city": "TEMPE",
            "state": "AZ",
            "postal_code": "852833717",
            "telephone_number": "480-751-1020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROUSSARD",
        "first_name": "ANNA",
        "middle_name": "RENE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-04-02",
        "last_updated": "2008-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "AZ",
            "license": "LPC-12927",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "AZ",
            "license": "LPC-12927",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "RENE",
            "last_name": "BROUSSARD",
            "credential": "L.P.C.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Valerie A Brodsky, D.O.
• Lauren Brogan, M.S., CCC-SLP
• Lynda Jane Broky, R. N.
• Brookdale Senior Living Communities, Inc.
• Glenn C Brooks, PT
• Ayana Elizabeth Brown
• Conrad A. Brown, M.C.
• Erica Brown, NMD
• Ethera D. Brown, PHD
• Jacob Brown, BEHAVIOR TECHNICIAN

• Professional Counselor in Tempe, AZ
• Providers in Tempe, AZ by specialty
• Professional Counselor in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.