MISS CHARNELLE L BROADDUS (NPI# 1316581341) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1316581341 |
| Entity Type | Individual |
| Full Name | MISS CHARNELLE L BROADDUS |
| Practice Address |
2600 Sw Holden St Seattle WA 98126-3505 |
| Practice Telephone | 2069337055 |
| Enumeration Date | 2019-11-02 |
| Last Update Date | 2019-11-02 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TH0100X |
Psychologist Specialization: Health Service |
WA | Behavioral Health & Social Service Providers |
| Street Address |
2600 SW HOLDEN ST |
| City | SEATTLE |
| State | WA |
| Zip Code | 98126-3505 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194728105 | Navos | Counselor | 2600 Sw Holden St, Seattle, WA 98126-3505 | 2005-05-23 |
| 1285234823 | Cardett E Geohagen | Counselor | 2600 Sw Holden St, Seattle, WA 98126-3505 | 2020-10-30 |
| 1245838192 | Victoria Chambers | Counselor | 2600 Sw Holden St, Seattle, WA 98126-3505 | 2020-10-13 |
| 1093313876 | Baylee Elizabeth Bortz | Registered Nurse | 2600 Sw Holden St, Seattle, WA 98126-3505 | 2020-10-13 |
| 1821605668 | Ciera Coyan | Student in an Organized Health Care Education/Training Program | 2600 Sw Holden St, Seattle, WA 98126-3505 | 2020-09-25 |
| 1609482736 | Jude Walker | Counselor | 2600 Sw Holden St, Seattle, WA 98126-3505 | 2020-09-23 |
| 1316553555 | Blake Aubery Phillips | Technician, Pathology | 2600 Sw Holden St, Seattle, WA 98126-3505 | 2020-09-22 |
| 1962018192 | Sean Ambrose | Student in an Organized Health Care Education/Training Program | 2600 Sw Holden St, Seattle, WA 98126-3505 | 2020-09-22 |
| 1285249060 | Michael Anthony Trujillo | Counselor | 2600 Sw Holden St, Seattle, WA 98126-3505 | 2020-09-09 |
| 1013521251 | Joyce Kristine Aquino | Counselor | 2600 Sw Holden St, Seattle, WA 98126-3505 | 2020-09-04 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750926341 | Andre L Cherry | Counselor | Navos - West Seattle, 2600 Sw Holden St, Seattle, WA 98126 | 2019-11-07 |
| 1477071314 | Hailey Justine Long | Registered Nurse | 5444 29th Ave Sw, Seattle, WA 98126 | 2017-08-30 |
| 1952824153 | Margaret Jane Oliver | Behavior Technician | 7942 29th Ave Sw, Seattle, WA 98126 | 2017-07-19 |
| 1538610282 | Kathleen Unterreiner Licsw | Community/Behavioral Health | 3261 Sw Avalon Way, Apt 411, Seattle, WA 98126 | 2016-10-18 |
| 1689123507 | Omotade Adeola Mallum | Occupational Therapy Assistant | 9408 35th Ave Sw, Unit B, Seattle, WA 98126 | 2016-10-04 |
| 1598211732 | Christopher Shawn Osler | Physical Therapy Assistant | 7346 32nd Ave Sw, Seattle, WA 98126 | 2016-08-28 |
| 1871989368 | Sara Lynne Smith | Counselor | 5225 35th Avenue South West, Seattle, WA 98126 | 2015-04-10 |
| 1689083032 | Kristine Ellyn Highlander | Nurse Practitioner | 2600 Sw Holden St., Navos Inpatient Services, Seattle, WA 98126 | 2014-08-11 |
| 1346657814 | Buu Bui | Family Medicine | 4550 Fauntleroy Way Sw # Ms 206-01, Seattle, WA 98126 | 2014-07-16 |
| 1598015950 | Kimberly Pendergrass | Social Worker | 2600 S. W. Holden Street, Seattle, WA 98126 | 2012-09-13 |
| Find all providers in zip 98126 | ||||
| Taxonomy Code | 103TH0100X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Health Service |
| A psychologist, certified/licensed at the independent practice level in his/her state, who is duly trained and experienced in the delivery of direct, preventative, assessment, and therapeutic intervention services to individuals whose growth, adjustment, or functioning is actually impaired or is demonstrably at high risk of impairment (1974). |
| Notes: Source: National Register of Health Service Providers in Psychology website http://www.nationalregister.org/about_NR.html [7/1/2006: modified title, added definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508255035 | Hong Zheng | Psychologist | 401 Ne Northgate Way Spc 465, Seattle, WA 98125-8514 | 2015-01-21 |
| 1891338919 | Sonja Marie Davalos | Psychologist | 3808 S Angeline St, Seattle, WA 98118-1712 | 2019-10-21 |
| 1184707374 | Philip Weinstein | Psychologist | 1959 Ne Pacific St, Seattle, WA 98195-0001 | 2006-10-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760036842 | Koinonia Center LLC | Psychologist | 11507 S Keeney Rd, Spokane, WA 99224-9625 | 2019-07-28 |
| 1982634069 | Julie A Rickard | Psychologist | 330 King St., Ste 5, Wenatchee, WA 98801 | 2006-07-04 |
| 1174909212 | Susan Diehl | Psychologist | 4526 Federal Ave, Everett, WA 98203-2132 | 2015-07-30 |
| 1871805200 | Jennifer Lynn Barth | Psychologist | 3322 Broadway, Everett, WA 98201-4425 | 2010-07-14 |
| 1700854635 | Burton T Kerr | Psychologist | 9600 Veterans Dr, Attn: A-116-mhc, Tacoma, WA 98493-5000 | 2006-03-08 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.