MRS. JACQUELINE BROADWAY LCMHC, LCAS
NPI 1861913097
Counselor - Mental Health in Wilmington, NC
About Mrs. Jacqueline Broadway Lcmhc, Lcas NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MRS. JACQUELINE BROADWAY LCMHC, LCAS (NPI 1861913097) is an individual mental health provider in Wilmington, North Carolina, licensed in North Carolina (13518) and active in the NPI registry since June 2017. She has opted out of Medicare through January 1, 2028 and remains eligible to order and refer.
NPPES Registry Identity
Specialties & Licenses 2
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.
Medicare Enrollment Status
Opted out of Medicare
Mrs. Jacqueline Broadway Lcmhc, Lcas has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from January 1, 2024 through January 1, 2028.
Other Providers at the Same Location NPPES 3
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
WILMINGTON, NC 28403
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 Jacqueline Broadway's NPI number?
The NPI number for Jacqueline Broadway is 1861913097. It was assigned to this individual provider in the NPPES registry on June 28, 2017.
Where is Jacqueline Broadway located?
Jacqueline Broadway practices at 5919 Oleander Dr Ste 121, Wilmington, NC 28403. The listed phone number is (910) 210-6160.
What is Jacqueline Broadway's specialty?
The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.
Is Jacqueline Broadway enrolled in Medicare?
No. Jacqueline Broadway has opted out of Medicare through January 1, 2028. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out. The provider remains eligible to order and refer services for Medicare patients.
What insurance does Jacqueline Broadway accept?
Health plans from Blue Cross and Blue Shield of NC list Jacqueline Broadway 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 Jacqueline Broadway was last updated on September 20, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.
# Mrs. Jacqueline Broadway, LCMHC, LCAS · NPI 1861913097
Mental Health provider in Wilmington, North Carolina. Individual provider, active in the CMS NPPES registry since June 28, 2017.
## Identity
- **NPI:** 1861913097 (Entity type: Individual)
- **Enumerated:** June 28, 2017
- **Primary specialty:** Counselor - Mental Health · taxonomy 101YM0800X
- **State license:** 13518 (North Carolina)
- **Sole proprietor:** No
## Practice location
- **Address:** 5919 OLEANDER DR STE 121, Wilmington, NC 28403-4757
- **Phone:** (910) 210-6160
## Medicare
- **Medicare:** Opted out of Medicare (opt-out affidavit on file, in effect through January 1, 2028); services are provided under private contract
## Record status
- **NPPES last updated:** September 20, 2021
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Source: [NPI Profile](https://npiprofile.com/npi/1861913097) · Data from the CMS NPPES public registry.