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General NPI Number Information
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NPI Number | 1982621462
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Entity Type | Individual
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Provider Name | JOHANNA LYNNE BROUGHTON LICSW LADC
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Gender | Female
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Dates
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Enumeration Date | 07/17/2006
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 30 MIRONA ROAD EXTENSION SUITE 3
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City | PORTSMOUTH
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State | NH
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Zip | 03801
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Country | US
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Telephone | 603-664-1010
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Fax | 603-766-3141
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Provider Business Mailing Address
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Address Line | 30 MIRONA ROAD EXTENSION SUITE 3
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City | PORTSMOUTH
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State | NH
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Zip | 03801
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Country | US
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Telephone | 603-436-7959
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Fax | 603-766-3141
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 513
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License Number State | NH
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Taxonomy #2
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | 1006
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License Number State | NH
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