Individual provider Active NPI

Debra A Broadley, MA, LMHC

  • Mental Health Counselor
  • Melrose, MA
National Provider Identifier
1851585558
Registry record updated Sep 5, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
35 Laurel St
Melrose, MA 02176-4023
Phone
(781) 662-1622
NPI assigned
Sep 5, 2007
Last updated
Sep 5, 2007By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 5, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X MA Primary

Addresses

Primary practice location

35 Laurel St
Melrose, MA 02176-4023

Mailing address

35 Laurel St
Melrose, MA 02176-4023
Phone (781) 662-1622

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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

Enrollment IDStateProvider typePAC IDDetails
I20240402000308 MA Practitioner - Mental Health Counselor 1557719499 Practice locations: Boston, MA

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Boston, MA 02110
Phone (617) 877-1379

210 S St
Apt 3 5
Boston, MA 01801

400 W Cummings Park
Suite 3700
Woburn, MA 01801-6628

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
000006363MAMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1188950400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1188950400000",
    "number": "1851585558",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "35 LAUREL ST",
            "city": "MELROSE",
            "state": "MA",
            "postal_code": "021764023",
            "telephone_number": "781-662-1622"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "35 LAUREL ST",
            "city": "MELROSE",
            "state": "MA",
            "postal_code": "021764023",
            "telephone_number": "781-662-1622"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROADLEY",
        "first_name": "DEBRA",
        "middle_name": "A",
        "credential": "MA, LMHC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-09-05",
        "last_updated": "2007-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Melrose, MA

Sources for this page

Verify at the official NPI Registry.