Provider Demographics
NPI:1447866355
Name:BROMBERG, CAROLINE CHRISTIAN (PSYD)
Entity type:Individual
Prefix:
First Name:CAROLINE
Middle Name:CHRISTIAN
Last Name:BROMBERG
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2016 STONEGATE TRL STE 112
Mailing Address - Street 2:
Mailing Address - City:VESTAVIA HLS
Mailing Address - State:AL
Mailing Address - Zip Code:35242-2249
Mailing Address - Country:US
Mailing Address - Phone:205-440-6292
Mailing Address - Fax:205-313-3177
Practice Address - Street 1:2016 STONEGATE TRL STE 112
Practice Address - Street 2:
Practice Address - City:VESTAVIA HLS
Practice Address - State:AL
Practice Address - Zip Code:35242-2249
Practice Address - Country:US
Practice Address - Phone:205-440-6292
Practice Address - Fax:205-313-3177
Is Sole Proprietor?:No
Enumeration Date:2020-09-17
Last Update Date:2025-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL2290103TP2701X, 103T00000X, 103TB0200X, 103TC0700X, 103TC1900X, 103TF0000X, 103TP0814X
NY106915-01103TC0700X
NY017776103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103TP2701XBehavioral Health & Social Service ProvidersPsychologistGroup Psychotherapy
No103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & Behavioral
No103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling
No103TF0000XBehavioral Health & Social Service ProvidersPsychologistFamily
No103TP0814XBehavioral Health & Social Service ProvidersPsychologistPsychoanalysis