Individual provider Active NPI

Heather Brooke Hanson Broome, LMHC

  • Mental Health Counselor
  • Renton, WA
National Provider Identifier
1639474901
Registry record updated Jun 4, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
LH60770357 Issued in WA
Practice address
306 Wells Ave S Unit a
Renton, WA 98057-2786
Phone
(206) 566-9853
NPI assigned
Jan 18, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 4, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X LH60770357 WA Primary

Addresses

Primary practice location

306 Wells Ave S Unit a
Renton, WA 98057-2786

Mailing address

306 Wells Ave S Unit a
Renton, WA 98057-2786
Phone (206) 566-9853

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Oct 3, 2024 through Oct 3, 2026

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
LH60770357WAMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1295308800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1559606400000",
    "number": "1639474901",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "306 WELLS AVE S UNIT A",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "980572786",
            "telephone_number": "206-566-9853"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "306 WELLS AVE S UNIT A",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "980572786",
            "telephone_number": "206-566-9853"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROOME",
        "first_name": "HEATHER",
        "middle_name": "BROOKE HANSON",
        "credential": "LMHC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-01-18",
        "last_updated": "2019-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WA",
            "license": "LH60770357",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Renton, WA

Sources for this page

Verify at the official NPI Registry.