Jillian Broeckert, LCMHC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

8390625-6004 Issued in UT

Practice address

1420 W 360 N
Saint George, UT 84770-4653

Phone

(435) 359-6798

NPI assigned

Jan 6, 2016

Sex

Female

Sole proprietor

Yes

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

Enrolled in MN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1452038400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1452038400000",
    "number": "1740646785",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1420 W 360 N",
            "city": "SAINT GEORGE",
            "state": "UT",
            "postal_code": "847704653",
            "telephone_number": "435-359-6798"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1420 W 360 N",
            "city": "SAINT GEORGE",
            "state": "UT",
            "postal_code": "847704653",
            "telephone_number": "435-359-6798"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROECKERT",
        "first_name": "JILLIAN",
        "credential": "LCMHC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-01-06",
        "last_updated": "2016-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "UT",
            "license": "8390625-6004",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Drake Broadbent, REGISTERED NURSE
• Holly Broadbent
• Lacey Broadbent
• Alexa Brandie Brock
• Virgil W. Brockbank, PH.D.
• Emily Bromfield
• Taunya Bronson, LASUDC
• Leon S Brook, CRNA
• Sarah Brianne Brook, DPT
• Daren Brooks, D.O.

• Mental Health Counselor in St George, UT
• Providers in St George, UT by specialty
• Mental Health Counselor in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.