Mrs Shirley Marie Broadwater, MS - Psychologist in Fayetteville, PA

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Mrs Shirley Marie Broadwater, MS is a Psychologist - Counseling based in Fayetteville, Pennsylvania. Mrs Shirley Marie Broadwater is licensed to practice in Pennsylvania (license number PS005001-L) and her current practice location is 1111 Houser Rd, Fayetteville, Pennsylvania. She can be reached at her office (for appointments etc.) via phone at (717) 352-2857.

NPI number for Mrs Shirley Marie Broadwater is 1659583599 and her current mailing address is 1111 Houser Rd, Fayetteville, Pennsylvania. She does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1659583599.

Contact Information

Mrs Shirley Marie Broadwater, MS
1111 Houser Rd,
Fayetteville, PA 17222-9731
(717) 352-2857
(717) 352-2857

Map and Direction




Healthcare Provider's Profile

Full NameMrs Shirley Marie Broadwater
GenderFemale
SpecialityPsychologist - Counseling
Location1111 Houser Rd, Fayetteville, Pennsylvania
Accepts Medicare AssignmentsDoes not participate in Medicare Program. She may not accept medicare assignment.
  NPI Data:
  • NPI Number: 1659583599
  • Provider Enumeration Date: 05/04/2007
  • Last Update Date: 07/08/2007

Medical Identifiers

Medical identifiers for Mrs Shirley Marie Broadwater such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1659583599NPI-NPPES
BR519094OtherPAPIN

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
103TC1900XPsychologist - Counseling PS005001-L (Pennsylvania)Primary

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mrs Shirley Marie Broadwater is NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Mrs Shirley Marie Broadwater, MS
1111 Houser Rd,
Fayetteville, PA 17222-9731

Ph: (717) 352-2857		Mrs Shirley Marie Broadwater, MS
1111 Houser Rd,
Fayetteville, PA 17222-9731

Ph: (717) 352-2857

Reviews and Comments


Psychologist in Fayetteville, PA


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