Type 1 · Individual ✓ Active NPI ✓ Valid NPI checksum

Prof. Staci Broadwell, PSY.D

Clinical Psychologist in Phoenix, AZ · enumerated 2009 · practices at Mountain Park Health Center.

Data current as of Jul 13, 2026 · sourced from CMS NPPES

National Provider Identifier

1467696419

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Registry record

Entity type Individual (Type 1)

Name Prof. Staci Broadwell

Credential PSY.D

Sex Female

Practice address 3830 E Van Buren St, Phoenix, AZ, 85008

Phone (602) 243-7277

Fax (602) 286-0808

Enumeration date Apr 21, 2009

Last updated in NPPES Jun 12, 2024

Taxonomy & licenses

103TC0700X Clinical Psychologist Behavioral Health & Social Service Providers · License 017898 (NY) Secondary

103TC0700X Clinical Psychologist Behavioral Health & Social Service Providers · License 4519 (AZ) Primary

PSYD · Doctor of Psychology: A clinical doctorate in psychology focused on professional practice. About the PSYD credential

Other identifiers

Identifier	Type	State	Issuer
206766	Medicaid	AZ	-

What is an NPI number?

A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes, even if the provider moves or changes specialty.

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Frequently asked questions

Is this the official NPI registry?

No. NPI Portal is a private site built on public CMS NPPES data. The official registry is npiregistry.cms.hhs.gov, operated by CMS.

What specialty is Staci Broadwell?

Staci Broadwell is registered in NPPES with the primary taxonomy of Clinical Psychologist. The taxonomy code describes the provider's classification and area of specialization for claims and credentialing.

Other providers at this practice address

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Keith Noback Family Medicine Physician · Phoenix, AZ NPI 1154437317 Mountain Park Health Center Federally Qualified Health Center (FQHC) · Phoenix, AZ NPI 1386741668 Natisha Andrews Dental Hygienist · Phoenix, AZ NPI 1801048434 Michelle Galster Clinical Social Worker · Phoenix, AZ NPI 1033428693 Jennifer Santerre Women's Health Nurse Practitioner · Phoenix, AZ NPI 1306278759 Hoda Mohamed Women's Health Nurse Practitioner · Phoenix, AZ NPI 1124431366 Kirsten Adamson Registered Dietitian · Phoenix, AZ NPI 1952701013 Terra Johnson Registered Dietitian · Phoenix, AZ NPI 1407249279

Source: CMS NPPES (public data). Snapshot 2026-07-13. Provider record last updated 2024-06-12.