Active NPI
Broderick Harper, LCADC
- Addiction (Substance Use Disorder) Counselor
- Galloway, NJ
National Provider Identifier
1750899795
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- 37LC00243700
- Practice address
- 313 E Jimmie Leeds Rd
Galloway, NJ 08205-4119 - Phone
- (609) 498-6009
- NPI assigned
- Jan 11, 2018
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 37LC00243700 | NJ | Primary |
Addresses
Primary practice location
313 E Jimmie Leeds Rd
Galloway, NJ 08205-4119
Mailing address
313 E Jimmie Leeds Rd
Galloway, NJ 08205-4119
Phone (609) 498-6009
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 37LC00243700 | Other | NJ | SUBSTANCE ABUSE |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 37LC00243700 | NJ | MD | Addiction (Substance Use Disorder) Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1515628800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1515628800000",
"number": "1750899795",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "313 E JIMMIE LEEDS RD",
"city": "GALLOWAY",
"state": "NJ",
"postal_code": "082054119",
"telephone_number": "609-498-6009",
"fax_number": "609-241-6573"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "313 E JIMMIE LEEDS RD",
"city": "GALLOWAY",
"state": "NJ",
"postal_code": "082054119",
"telephone_number": "609-498-6009"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HARPER",
"first_name": "BRODERICK",
"name_prefix": "Dr.",
"credential": "LCADC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2018-01-11",
"last_updated": "2018-01-11",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "NJ",
"license": "37LC00243700",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "SUBSTANCE ABUSE",
"identifier": "37LC00243700",
"state": "NJ"
}
],
"endpoints": [],
"other_names": []
}Other providers in Galloway, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.