Provider Demographics
NPI:1689389538
Name:ARAD BROOME, NAOMI (MA, BC-DMT, LAC LCAT)
Entity Type:Individual
Prefix:
First Name:NAOMI
Middle Name:
Last Name:ARAD BROOME
Suffix:
Gender:F
Credentials:MA, BC-DMT, LAC LCAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:129 S MAPLE AVE
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07081-1907
Mailing Address - Country:US
Mailing Address - Phone:908-291-2898
Mailing Address - Fax:
Practice Address - Street 1:129 S MAPLE AVE
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07081-1907
Practice Address - Country:US
Practice Address - Phone:908-291-2898
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-16
Last Update Date:2023-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY002635225600000X
NJ37AC00129100101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty
No225600000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDance Therapist