Nikki Brodsky-Jones, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

3720 Issued in AZ

Practice address

1237 S Val Vista Dr # 108
Mesa, AZ 85204-6401

Phone

(480) 776-3392

Fax

(480) 396-0532

NPI assigned

Nov 9, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective May 6, 2019 through May 6, 2027

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1163030400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1200528000000",
    "number": "1780754135",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1237 S VAL VISTA DR # 108",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852046401",
            "telephone_number": "480-776-3392",
            "fax_number": "480-396-0532"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1237 S VAL VISTA DR # 108",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852046401",
            "telephone_number": "480-776-3392",
            "fax_number": "480-396-0532"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRODSKY-JONES",
        "first_name": "NIKKI",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-09",
        "last_updated": "2008-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "AZ",
            "license": "3720",
            "primary": true
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "AZ",
            "license": "3720",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Caylie Brock, LAC
• Clint Brock
• Anissa Brockman, RPH
• Mary Louise Brockmeier, MT-BC
• McKenna I Brodrick, ED.S, MS, LPC
• Joshua Brody, LPC
• Nadine Paige Broekemeier
• Dawn Diane Brokaw, MD
• Stephanie Suzanne Brokaw, PHARMD
• Candy Bromley

• Clinical Psychologist in Mesa, AZ
• Providers in Mesa, AZ by specialty
• Clinical Psychologist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2008; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.