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KRISTNE DANIELLE BROADWAY LPC
NPI 1255875373
Counselor - Professional in Smyrna, GA

Active since December 08, 2016PECOS EnrolledAccepts Medicare Assignment
400 TECHNOLOGY CT SE STE J, SMYRNA, GA 30082(770) 431-2354(770) 436-7143 Get Directions Write a Review

NPPES record last updated: January 8, 2026. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Jan 8, 2026, Dec 24, 2025, Feb 14, 2025 (3 updates tracked since 2025).

About Kristne Danielle Broadway Lpc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KRISTNE DANIELLE BROADWAY LPC (NPI 1255875373) is an individual professional provider in Smyrna, Georgia, licensed in Georgia (LPC012115) and active in the NPI registry since December 2016. She is enrolled in Medicare PECOS and is a graduate of Other (2016).

NPPES Registry Identity

NPI1255875373
Entity TypeIndividualFemale
Primary Taxonomy101YP2500X
Provider Legal NameKRISTNE DANIELLE BROADWAYCredential: LPC
Location Address400 TECHNOLOGY CT SE STE JSmyrna, GA 30082-5237
Mailing Address4800 N Scottsdale Rd Ste 2500Scottsdale, AZ 85251-7630
Phone(770) 431-2354
Fax(770) 436-7143
Sole ProprietorNo
Medical School CMSOtherGraduated 2016
Enumeration DateDecember 8, 2016
Last NPPES UpdateJanuary 8, 20263 updates tracked since enumeration
NPPES CertifiedJanuary 8, 2026
✔ NPI 1255875373 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · ProfessionalBehavioral Health & Social Service Providers
Taxonomy Code101YP2500X
License✔ Licensed in GA · LPC012115
400 TECHNOLOGY CT SE STE J, Smyrna, GA 30082
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Kristne Danielle Broadway Lpc is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID6901257039
PECOS Enrollment IDI20240112001758
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Kristne Broadway reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Personal Recovery Network LLC
27 mi
Psychiatry
250 CORPORATE CENTER CT
Stockbridge, GA 30281
  • Reassigned Medicare billing, Georgia enrollment
  • 592 clinicians in this Medicare group
NPI 1881990869 (770) 389-8100

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

TOMMIE MACK RICHARDSON MD
Psychiatry & Neurology (Psychiatry)
400 TECHNOLOGY CT SE STE J
SMYRNA, GA 30082
Cobb County (770) 431-2354
ANGELA NICOLE BELL PMHNP
Nurse Practitioner (Psychiatric/Mental Health)
400 TECHNOLOGY CT SE STE J
SMYRNA, GA 30082
Cobb County (770) 431-2354
DAVID SHELTON LMFT
Marriage & Family Therapist
400 TECHNOLOGY CT SE STE J
SMYRNA, GA 30082
Cobb County (770) 431-2354
JAMES SAMPLE ELLIOTT JR. LPC
Counselor (Professional)
400 TECHNOLOGY CT SE STE J
SMYRNA, GA 30082
Cobb County (770) 431-2354
MARION LYNNE CHAPMAN PHD, LPC
Counselor (Professional)
400 TECHNOLOGY CT SE STE J
SMYRNA, GA 30082
Cobb County (770) 431-2354
SUWANNE TAQUISE SANCKO LPC
Counselor (Professional)
400 TECHNOLOGY CT SE STE J
SMYRNA, GA 30082
Cobb County (770) 431-2354
APHRODITISE CORELLE EDGE LPC
Counselor (Professional)
400 TECHNOLOGY CT SE STE J
SMYRNA, GA 30082
Cobb County (770) 431-2354
MRS. LATASHA LASSETER MARTIN PMHNP-BC, FNP-C
Nurse Practitioner (Psychiatric/Mental Health)
400 TECHNOLOGY CT SE STE J
SMYRNA, GA 30082
Cobb County (770) 431-2354

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kristne Broadway's NPI number?

The NPI number for Kristne Broadway is 1255875373. It was assigned to this individual provider in the NPPES registry on December 8, 2016.

Where is Kristne Broadway located?

Kristne Broadway practices at 400 Technology Ct SE Ste J, Smyrna, GA 30082. The listed phone number is (770) 431-2354.

What is Kristne Broadway's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Professional, with taxonomy code 101YP2500X.

Is Kristne Broadway enrolled in Medicare?

Yes. Kristne Broadway is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organization bills Medicare for Kristne Broadway's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Kristne Broadway reassigns Medicare benefits to Personal Recovery Network LLC (Stockbridge, GA). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Kristne Broadway's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Kristne Broadway was last updated on January 8, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.