CARLY BROADHEAD MA NCC LPC NPI 1275975914

NPI Information

  • NPI: 1275975914
  • Provider Name: CARLY BROADHEAD, MA, NCC, LPC
  • Classification: Counselor - 101Y00000X
  • Entity Type: Individual
  • Address: 3071 E FRANKLIN RD STE 201
    MERIDIAN, ID
    ZIP 83642
  • Phone: (208) 807-2877

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NPI Details

Carly Broadhead, MA, NCC, LPC is a counselor in Meridian, ID. The provider is a provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master's degree and clinical experience and supervision for licensure or certification. Carly Broadhead, MA, NCC, LPC NPI is 1275975914. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

3071 E FRANKLIN RD STE 201
MERIDIAN, ID
ZIP 83642
Phone: (208) 807-2877

The enumeration date for this NPI number is 7/23/2013 and was last updated on 3/7/2019.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1101Y00000XCounselorYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1MH3237MEDICAIDALASKA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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