DR. CAROLYN R. BROOMALL (NPI# 1760534515) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1760534515 |
| Entity Type | Individual |
| Full Name | DR. CAROLYN R. BROOMALL |
| Credential | PSY.D., CCDP, CP |
| Practice Address |
611 N Caln Rd Coatesville PA 19320-2203 |
| Practice Telephone | 6103843833 |
| Practice Fax Number | 6103843833 |
| Mailing Telephone | 6103843833 |
| Mailing Fax Number | 6103843833 |
| Enumeration Date | 2007-01-18 |
| Last Update Date | 2016-03-11 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 103T00000X | Psychologist | PS015083 | PA | Behavioral Health & Social Service Providers |
| N | 103TA0400X |
Psychologist Specialization: Addiction (Substance Use Disorder) |
PS015083 | PA | Behavioral Health & Social Service Providers |
| Y | 103TC0700X |
Psychologist Specialization: Clinical |
PS015083 | PA | Behavioral Health & Social Service Providers |
| N | 103TC1900X |
Psychologist Specialization: Counseling |
PS015083 | PA | Behavioral Health & Social Service Providers |
| N | 103TP2701X |
Psychologist Specialization: Group Psychotherapy |
PS015083 | PA | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PA | 001873284 | 05 |
| Street Address |
611 N CALN RD |
| City | COATESVILLE |
| State | PA |
| Zip Code | 19320-2203 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962029306 | Ara Dadivanyan | Psychiatry & Neurology | 201 Reeceville Rd., Brandywine Hospital, Coatesville, PA 19320 | 2020-07-01 |
| 1669098919 | Sara Mostafa | Psychiatry & Neurology | Brandy Wine Hospital, 201 Reeceville Rd, Coatesville, PA 19320 | 2020-06-23 |
| 1225654072 | Laurie Bond | Counselor | 774 East Lincoln Highway, Coatesville, PA 19320 | 2020-06-17 |
| 1356964506 | Timothy Robert Derosa | Psychiatry & Neurology | Brandywine Hospital 201 Reeceville Rd., Coatesville, Pa, PA 19320 | 2020-05-22 |
| 1184264632 | Evolve Individual Services, LLC | Counselor | 135 E Chestnut St, 204, Coatesville, PA 19320 | 2020-01-13 |
| 1649824111 | Angela Lynne Sylvina | Social Worker | 1825 E Lincoln Highway, Coatesville, PA 19320 | 2019-08-01 |
| 1629540257 | Rhonda Jean Sanford | Social Worker | Coatesville Vamc, Attn: Rhonda Sanford, Lcsw, 1400 Blackhorse Hill Rd, Bldg 57, Rm 227, Coatesvillle, PA 19320 | 2018-12-20 |
| 1528540499 | Jetquatta Parker | Licensed Practical Nurse | 786 Coates St, Coatesville, PA 19320 | 2018-09-06 |
| 1639608052 | Shafkat Hussain | Pharmacist | 800 East Lincoln Highway, Coatesville, PA 19320 | 2017-06-08 |
| 1790222032 | Elizabeth Barnett | Counselor | 2034crest Dr, Coatesville, PA 19320 | 2017-01-25 |
| Find all providers in zip 19320 | ||||
| Taxonomy Code | 103TC0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548328479 | Lori Ann Nelsen Luneburg | Psychologist | 1611 Stargazets Rd, Coatesville, PA 19320 | 2006-12-04 |
| 1114926177 | Julia Ann Stone | Psychologist | 1400 Blackhorse Hill Rd, Coatesville Va Medical Center, Coatesville, PA 19320-2040 | 2005-07-20 |
| 1902441157 | Ashley Sutton | Psychologist | 1400 Blackhorse Hill Rd, Coatesville, PA 19320-2040 | 2019-11-12 |
| 1851714943 | Justin Charles | Psychologist | 1400 Blackhorse Hill Rd, Building 27, Coatesville, PA 19320-2040 | 2014-01-27 |
| 1427301480 | Jeffrey Schweitzer | Psychologist | 1400 Blackhorse Hill Rd, Coatesville, PA 19320-2040 | 2012-10-16 |
| 1174800528 | Stephanie Adam | Psychologist | 1400 Blackhorse Hill Rd, Coatesville, PA 19320-2040 | 2011-11-14 |
| 1487951877 | Kurrie Wells | Psychologist | 1400 Blackhorse Hill Rd, Coatesville, PA 19320 | 2011-02-21 |
| 1326369927 | Thomas Bortner | Psychologist | 1400 Blackhorse Hill Rd, Coatesville, PA 19320-2040 | 2010-06-17 |
| 1013146117 | Amanda Shannon Vaught | Psychologist | 1400 Blackhorse Hill Rd, Coatesville, PA 19320-2040 | 2009-07-09 |
| 1780859967 | Danielle Theresa Farabaugh | Psychologist | 1400 Blackhorse Hill Rd, Coatesville, PA 19320-2040 | 2008-04-28 |
| Find all providers in COATESVILLE | ||||
| City | COATESVILLE |
| Zip Code | 19320 |
Please comment or provide details below to improve the information on DR. CAROLYN R. BROOMALL.
| 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.