Raven Broden

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

Practice address

3010 Monroe Rd Ste 108G
Charlotte, NC 28205-7533

Phone

(980) 777-3980

NPI assigned

Sep 26, 2026

Sex

Female

Sole proprietor

No

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

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.

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

{
    "created_epoch": "1790380800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790380800000",
    "number": "1588577878",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3010 MONROE RD STE 108G",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282057533",
            "telephone_number": "980-777-3980"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3010 MONROE RD STE 108G",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282057533",
            "telephone_number": "980-777-3980"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRODEN",
        "first_name": "RAVEN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-09-26",
        "last_updated": "2026-09-26",
        "certification_date": "2026-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hayley Keen Brock, OTR/L
• Jack Gilbert Brock Jr., M.D.
• Krystal Dawn Brock, LMFTA
• Jeffrey Clarke Brockman, LPCA
• Kathryn Elizabeth Brockway, PA-C
• Staci Huska Broderick, M.S. CCC-SLP
• Shawnte N Brodie
• Megan Colleen Brogan, FNP
• Leigh Brogdon, PT
• Bethany Broj, PSY.D.

• Student in an Organized Health Care Education/Training Program in Charlotte, NC
• Providers in Charlotte, NC by specialty
• Student in an Organized Health Care Education/Training Program in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.