MS. DIANE ELAINE BROUDER LMFT
NPI 1811093719
Marriage & Family Therapist in Essex, CT

Active since September 16, 2006PECOS Enrolled
3 WILDWOOD MEDICAL CTR, ESSEX, CT 06426(860) 303-4108 Get Directions Write a Review

NPPES record last updated: August 7, 2021. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Aug 7, 2021, Apr 26, 2021 (2 updates tracked since 2021).

About Ms. Diane Elaine Brouder Lmft NPPES

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

MS. DIANE ELAINE BROUDER LMFT (NPI 1811093719) is an individual marriage & family therapist in Essex, Connecticut, licensed in Connecticut (000597CT) and active in the NPI registry since September 2006. She is enrolled in Medicare PECOS, maintains a secondary practice location in East Lyme, and is a graduate of Other (1992).

NPPES Registry Identity

NPI1811093719
Entity TypeIndividualFemale
Primary Taxonomy106H00000X
Provider Legal NameMS. DIANE ELAINE BROUDERCredential: LMFT
Location Address3 WILDWOOD MEDICAL CTREssex, CT 06426-1155
Mailing Address3 Wildwood Medical CtrEssex, CT 06426-1155 · (860) 303-4108 · Fax (860) 400-3043
Sole ProprietorYes
Medical School CMSOtherGraduated 1992
Enumeration DateSeptember 16, 2006
Last NPPES UpdateAugust 7, 20212 updates tracked since enumeration
NPPES CertifiedAugust 7, 2021
NPI 1811093719 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyMarriage & Family TherapistBehavioral Health & Social Service Providers
Taxonomy Code106H00000X
License Licensed in CT · 000597CT
Definition

A marriage and family therapist is a person with a master's degree in marriage and family therapy, or a master's or doctoral degree in a related mental health field with substantially equivalent coursework in marriage and family therapy, who receives supervised clinical experience, or a person who meets the state requirements to practice as a marriage and family therapist. A marriage and family therapist treats mental and emotional disorders within the context of marriage and family systems. A marriage and family therapist provides mental health and counseling services to individuals, couples, families, and groups.

3 WILDWOOD MEDICAL CTR, Essex, CT 06426

Other Names 1

Former Name (1)Ms. Diane Elaine Brouder Ma

Secondary Practice Location 1

Location 1126 Boston Post RdEast Lyme, CT 06333 · Phone (860) 303-4108 · Fax (860) 201-1009

Other Identifiers 2

Other000597CT · Ct State License For Marriage And Family Therapy
Medicaid004212635CT

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Enrolled in Medicare (PECOS)

Ms. Diane Elaine Brouder Lmft is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID4385179332
PECOS Enrollment IDI20241127001356
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 5

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

Acupuncturist
3 WILDWOOD MEDICAL CTR, 35 SAYBROOK ROAD
ESSEX, CT 06426
Naturopath
3 WILDWOOD MEDICAL CTR, THIRD STONE INTEGRATIVE HEALTH CENTER
ESSEX, CT 06426
Naturopath
3 WILDWOOD MEDICAL CTR
ESSEX, CT 06426
Nurse Practitioner
3 WILDWOOD MEDICAL CTR
ESSEX, CT 06426
Naturopath
3 WILDWOOD MEDICAL CTR
ESSEX, CT 06426

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1811093719, enumerated as an "individual" on September 16, 2006.

The provider is located at 3 WILDWOOD MEDICAL CTR ESSEX, CT 06426 and the phone number is (860) 303-4108.

Marriage & Family Therapist with taxonomy code 106H00000X.

The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.