Individual provider Active NPI

Johanna Lynne Broughton, LICSW LADC

  • Social Worker
  • Portsmouth, NH
National Provider Identifier
1982621462
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
1006 Issued in NH
Practice address
30 Mirona Road Extension
Suite 3
Portsmouth, NH 03801
Phone
(603) 664-1010
Fax
(603) 766-3141
NPI assigned
Jul 17, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 513 NH
Social Worker 104100000X 1006 NH Primary

Addresses

Primary practice location

30 Mirona Road Extension
Suite 3
Portsmouth, NH 03801

Mailing address

30 Mirona Road Extension
Suite 3
Portsmouth, NH 03801
Phone (603) 436-7959

Other identifiers 3

IdentifierTypeStateIssuer
115858OtherMMC PHO BHC P
30423349MedicaidNH
117879OtherBHN

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

LicenseStateTypeSpecialty
513NHMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1153094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1982621462",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 MIRONA ROAD EXTENSION",
            "address_2": "SUITE 3",
            "city": "PORTSMOUTH",
            "state": "NH",
            "postal_code": "03801",
            "telephone_number": "603-436-7959",
            "fax_number": "603-766-3141"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 MIRONA ROAD EXTENSION",
            "address_2": "SUITE 3",
            "city": "PORTSMOUTH",
            "state": "NH",
            "postal_code": "03801",
            "telephone_number": "603-664-1010",
            "fax_number": "603-766-3141"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROUGHTON",
        "first_name": "JOHANNA",
        "middle_name": "LYNNE",
        "name_prefix": "Ms.",
        "credential": "LICSW LADC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-17",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NH",
            "license": "513",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NH",
            "license": "1006",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MMC PHO BHC P",
            "identifier": "115858",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30423349",
            "state": "NH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BHN",
            "identifier": "117879",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Portsmouth, NH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.