James Broecker PA

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

JAMES BROECKER PA

Practice address

901 Dominion Dr
Hudson Counseling
Hudson, WI 54016-9326

Phone

(715) 531-6760

Fax

(715) 531-6761

NPI assigned

Apr 6, 2007

Organization subpart

No

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

Authorized official

Name

Mr. James Harold Broecker, MS, LMFT

Title

Lic. Marriage and Family Therapist

Phone

(651) 295-2409

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1175817600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1294617600000",
    "number": "1619090669",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2806 ITASCA AVE S",
            "city": "LAKELAND",
            "state": "MN",
            "postal_code": "550439741",
            "telephone_number": "715-531-6760",
            "fax_number": "715-531-6761"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 DOMINION DR",
            "address_2": "HUDSON COUNSELING",
            "city": "HUDSON",
            "state": "WI",
            "postal_code": "540169326",
            "telephone_number": "715-531-6760",
            "fax_number": "715-531-6761"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JAMES BROECKER PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-06",
        "last_updated": "2011-01-10",
        "status": "A",
        "authorized_official_last_name": "BROECKER",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "HAROLD",
        "authorized_official_title_or_position": "LIC. MARRIAGE AND FAMILY THERAPIST",
        "authorized_official_telephone_number": "651-295-2409",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MS, LMFT"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2011; 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.