Kelby Broddie, LMFT

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

LF61239188 Issued in WA

Practice address

4350 Cordata Pkwy Ste 102
Bellingham, WA 98226-8278

Phone

(360) 922-6977

NPI assigned

Sep 16, 2019

Sex

Male

Sole proprietor

No

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 WA

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

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Accent Counseling, Inc.

  • Mental Health Counselor
  • Bellingham, WA
  • NPI 1770009557
  Medicare reassignment NPD
• Village Family Service Center

  • Substance Abuse Rehabilitation Facility
  • Fargo, ND
  • NPI 1952679318
  NPD (past)

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

{
    "created_epoch": "1568592000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658880000000",
    "number": "1760032379",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4350 CORDATA PKWY STE 102",
            "city": "BELLINGHAM",
            "state": "WA",
            "postal_code": "982268278",
            "telephone_number": "360-922-6977"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4350 CORDATA PKWY STE 102",
            "city": "BELLINGHAM",
            "state": "WA",
            "postal_code": "982268278",
            "telephone_number": "360-922-6977"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRODDIE",
        "first_name": "KELBY",
        "credential": "LMFT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-09-16",
        "last_updated": "2022-07-27",
        "certification_date": "2022-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "WA",
            "license": "LF61239188",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Broadway Family Chiropractic Inc
• Amy K Brock, LMP
• Lila A Brockie, CPC
• Melinda Sianna Brockie, CPC
• Isabel Brockman, LICSWA
• Lisa N. Brodsky, ARNP
• Erika Bronstein, LCSW
• Kala Brood, SUDPT
• James Duffy Brook
• Chloe Marie Brookbank, OTR/L

• Marriage & Family Therapist in Bellingham, WA
• Providers in Bellingham, WA by specialty
• Marriage & Family Therapist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2022; 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.