Individual provider Active NPI

Allison Brodeur, LMFT

  • Marriage & Family Therapist
  • Greenville, NC
National Provider Identifier
1659339364
Registry record updated Mar 22, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
727 Issued in NC
Practice address
3483 Evans St Ste B
Greenville, NC 27834-4529
Phone
(252) 917-1559
NPI assigned
May 2, 2006
Last updated
Mar 22, 2019By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 22, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 727 NC Primary

Addresses

Primary practice location

3483 Evans St Ste B
Greenville, NC 27834-4529

Mailing address

3483 Evans St Ste B
Greenville, NC 27834-4529
Phone (252) 917-1559

Other practice location 1

101 Bethesda Dr
Greenville, NC 27834-7201
Phone (252) 758-7141

Other identifiers 1

IdentifierTypeStateIssuer
6105057MedicaidNC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
727NCMDAdvanced Practice Midwife

NPI Registry JSON

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

{
    "created_epoch": "1146528000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1553212800000",
    "number": "1659339364",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3483 EVANS ST STE B",
            "city": "GREENVILLE",
            "state": "NC",
            "postal_code": "278344529",
            "telephone_number": "252-917-1559"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3483 EVANS ST STE B",
            "city": "GREENVILLE",
            "state": "NC",
            "postal_code": "278344529",
            "telephone_number": "252-917-1559"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "101 Bethesda Dr",
            "address_purpose": "LOCATION",
            "city": "Greenville",
            "state": "NC",
            "postal_code": "278347201",
            "country_code": "US",
            "telephone_number": "252-758-7141",
            "fax_number": "252-758-2603",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BRODEUR",
        "first_name": "ALLISON",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-05-02",
        "last_updated": "2019-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "NC",
            "license": "727",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6105057",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2019; 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.