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

Q: 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.

Q: What is Kristne Broadway's specialty?

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

Q: 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 6 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.

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: August 02, 2026.

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

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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, and ordering and referring status from the CMS PECOS system.

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.

Other Providers at the Same Location NPPES 19

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

TOMMIE MACK RICHARDSON MD

Family Medicine (Addiction Medicine)