MATTHEW STUART BROUDY PHD
NPI 1649348145
Psychologist - Clinical in Lake Ridge, VA

Q: What is Matthew Broudy's NPI number?

The NPI number for Matthew Broudy is 1649348145. It was assigned to this individual provider in the NPPES registry on December 1, 2006.

Q: What is Matthew Broudy'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 Matthew Broudy 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 December 01, 2006

2239F TACKETTS MILL DRIVE, LAKE RIDGE, VA 22192(703) 490-0336(703) 490-4525 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 Matthew Stuart Broudy Phd NPPES

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

MATTHEW STUART BROUDY PHD (NPI 1649348145) is an individual clinical provider in Lake Ridge, Virginia, licensed in Virginia (0810003712) and active in the NPI registry since December 2006.

NPPES Registry Identity

NPI1649348145

Entity TypeIndividualMale

Primary Taxonomy103TC0700X

Provider Legal NameMATTHEW STUART BROUDYCredential: PHD

Location Address2239F TACKETTS MILL DRIVELake Ridge, VA 22192

Mailing Address2239f Tacketts Mill DriveLake Ridge, VA 22192 · (703) 490-0336 · Fax (703) 490-4525

Phone(703) 490-0336

Fax(703) 490-4525

Sole ProprietorNo

Enumeration DateDecember 1, 2006

Last NPPES UpdateJuly 8, 2007

✔ NPI 1649348145 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 VA · 0810003712

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.

2239F TACKETTS MILL DRIVE, Lake Ridge, VA 22192

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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 Matthew Broudy's NPI number?

The NPI number for Matthew Broudy is 1649348145. It was assigned to this individual provider in the NPPES registry on December 1, 2006.

Where is Matthew Broudy located?

Matthew Broudy practices at 2239F Tacketts Mill Drive, Lake Ridge, VA 22192. The listed phone number is (703) 490-0336.

What is Matthew Broudy'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 Matthew Broudy 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.