DR. MARY ELLEN BRODERICK PH.D.
NPI 1356484240
Psychologist - Clinical in Marianna, FL

Q: What is Mary Broderick's NPI number?

The NPI number for Mary Broderick is 1356484240. It was assigned to this individual provider in the NPPES registry on February 14, 2007.

Q: What is Mary Broderick's specialty?

The primary specialty registered for this NPI is Psychologist, specializing in Clinical, with taxonomy code 103TC0700X.

Q: When was this NPI record last updated?

The NPPES record for Mary Broderick was last updated on July 8, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 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.

Active since February 14, 2007

2902 MADISON ST, MARIANNA, FL 32446(850) 482-8830 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: August 16, 2026.

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About Dr. Mary Ellen Broderick Ph.d. NPPES

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

DR. MARY ELLEN BRODERICK PH.D. (NPI 1356484240) is an individual clinical provider in Marianna, Florida, licensed in Florida (PY 3181) and active in the NPI registry since February 2007.

NPPES Registry Identity

NPI1356484240

Entity TypeIndividualFemale

Primary Taxonomy103TC0700X

Provider Legal NameDR. MARY ELLEN BRODERICKCredential: PH.D.

Location Address2902 MADISON STMarianna, FL 32446-3450

Mailing Address1126 Stillwater DrDeland, FL 32720-2571 · (386) 734-5852

Phone(850) 482-8830

Sole ProprietorNo

Enumeration DateFebruary 14, 2007

Last NPPES UpdateJuly 8, 2007

✔ NPI 1356484240 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychologist · ClinicalBehavioral Health & Social Service Providers

Taxonomy Code103TC0700X

License✔ Licensed in FL · PY 3181

Definition

A psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in breadth -- one that is broadly inclusive of severe psychopathology -- and marked by comprehensiveness and integration of knowledge and skill from a broad array of disciplines within and outside of psychology proper. The scope of clinical psychology encompasses all ages, multiple diversities and varied systems.

2902 MADISON ST, Marianna, FL 32446

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Other Identifiers 2

Other75290FL · Bcbs Psychologist

Medicare ID-Type Unspecified75290FL · Psychologist

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 Mary Broderick's NPI number?

The NPI number for Mary Broderick is 1356484240. It was assigned to this individual provider in the NPPES registry on February 14, 2007.

Where is Mary Broderick located?

Mary Broderick practices at 2902 Madison St, Marianna, FL 32446. The listed phone number is (850) 482-8830.

What is Mary Broderick's specialty?

The primary specialty registered for this NPI is Psychologist, specializing in Clinical, with taxonomy code 103TC0700X.

When was this NPI record last updated?

The NPPES record for Mary Broderick was last updated on July 8, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 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.