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Contact Information

MONIQUE BROUSSARD
760 MONTAUK HWY
WATER MILL, NY11976-2600
 Phone: 347-754-7952
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Mental Health

101YM0800X
 

Group Psychotherapy

103TP2701X 62 Psychologist, Clinical
 

Health & Wellness Coach

171400000X
 

Pastoral

101YP1600X
 

Professional

101YP2500X
 

Psychoanalyst

102L00000X
 

Psychologist

103T00000X 62 Psychologist, Clinical
Indicates primary specialty

NPI Profile & details for MONIQUE BROUSSARD · (Female)

NPI Number 1841172855
Status Active
Credentials
Entity Individual
Enumeration date 07/22/2025
Last updated 07/22/2025 - About 11 months ago
Sole proprietor 1 Yes
Identifiers Not Available
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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