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IVY RAINE BROADRICK
NPI 1336739820
Counselor - Mental Health in Spokane, WA

Active since January 19, 2021PECOS Enrolled
107 S DIVISION ST, SPOKANE, WA 99202(509) 838-4651 Get Directions Write a Review

NPPES record last updated: October 13, 2021. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Oct 13, 2021, Mar 9, 2021, Jan 19, 2021 (3 updates tracked since 2021).

About Ivy Raine Broadrick NPPES

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

IVY RAINE BROADRICK (NPI 1336739820) is an individual mental health provider in Spokane, Washington, licensed in Washington (MC61221129) and active in the NPI registry since January 2021. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1336739820
Entity TypeIndividualFemale
Primary Taxonomy101YM0800X
Provider Legal NameIVY RAINE BROADRICK
Location Address107 S DIVISION STSpokane, WA 99202-1510
Mailing Address107 S Division StSpokane, WA 99202-1510 · (509) 838-4651
Phone(509) 838-4651
Sole ProprietorNo
Enumeration DateJanuary 19, 2021
Last NPPES UpdateOctober 13, 20213 updates tracked since enumeration
NPPES CertifiedOctober 13, 2021
✔ NPI 1336739820 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers
Taxonomy Code101YM0800X
License✔ Licensed in WA · MC61221129
Also ListedCounselorTaxonomy 101Y00000X · License CG61136424 (WA)
Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X
107 S DIVISION ST, Spokane, WA 99202
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Providence Health Plan.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Ivy Raine Broadrick is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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 Ivy Broadrick reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Frontier Behavioral Health
Same address
Community/Behavioral Health
107 S DIVISION ST
Spokane, WA 99202
  • Reassigned Medicare billing, Washington enrollment
  • 136 clinicians in this Medicare group
NPI 1861495327 (509) 838-4651

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.

JAMIE ANN WAGLEY BSN, RN
Registered Nurse
107 S DIVISION ST
SPOKANE, WA 99202
Spokane County (509) 838-4651
MICHAEL ROBERT SULLIVAN MSW
Social Worker
107 S DIVISION ST
SPOKANE, WA 99202
Spokane County (509) 838-4651
MRS. EMMA ELIZABETH MANNHALT
Counselor
107 S DIVISION ST
SPOKANE, WA 99202
Spokane County (509) 838-4651
MRS. JACQUELINE CLARISSA HOWARD
Counselor
107 S DIVISION ST
SPOKANE, WA 99202
Spokane County (509) 838-4651
CLAUDIA ELIZABETH MIMNA
Counselor
107 S DIVISION ST
SPOKANE, WA 99202
Spokane County (509) 838-4651
MR. JASON HALL MACKEY
Counselor
107 S DIVISION ST
SPOKANE, WA 99202
Spokane County (509) 838-4651
MELISSA RENEE WATSON
Social Worker
107 S DIVISION ST
SPOKANE, WA 99202
Spokane County (509) 838-4651
ALLAN D SANDERS MN ARNP
Nurse Practitioner (Family)
107 S DIVISION ST
SPOKANE, WA 99202
Spokane County (509) 838-4651

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 Ivy Broadrick's NPI number?

The NPI number for Ivy Broadrick is 1336739820. It was assigned to this individual provider in the NPPES registry on January 19, 2021.

Where is Ivy Broadrick located?

Ivy Broadrick practices at 107 S Division St, Spokane, WA 99202. The listed phone number is (509) 838-4651.

What is Ivy Broadrick's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.

Is Ivy Broadrick enrolled in Medicare?

Yes. Ivy Broadrick is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Ivy Broadrick's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Ivy Broadrick reassigns Medicare benefits to Frontier Behavioral Health (Spokane, WA). 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 Ivy Broadrick's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Ivy Broadrick accept?

Health plans from Providence Health Plan list Ivy Broadrick as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Ivy Broadrick was last updated on October 13, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years 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.