Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Dominique Victoria Broadnax, PSYD

Individual provider Clinical Psychologist · NPI 1679205074

Dominique Victoria Broadnax, PSYD is a Clinical Psychologist in Boston, Massachusetts. Qualified in 2024, 2 years ago. Practices with The Commonwealth of Massachusetts, a 144-clinician group and accepts Medicare assignment. Licensed in Massachusetts and Rhode Island.

Years since qualifying
2
Licensed in
MA, RI
In the registry since
2022
Specialties on file
2
What do these letters mean?
PSYD — Doctor of Psychology
A doctoral psychologist trained primarily for clinical practice.

See every abbreviation used in this directory →

Claim this listing Report a problem Suggest an edit

Practice location Address checks out

75 Fenwood Rd
Boston, MA 02115-6103
Phone: (617) 626-9300
Show map & directions

Directions in Google Maps · Apple Maps · OpenStreetMap

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Psychologist (primary) Taxonomy 103TC0700X · Licence PSY10001846 (MA)
Clinical Psychologist Taxonomy 103TC0700X · Licence PS02359 (RI)

Record details

NPI number1679205074
Entity typeIndividual (Type 1)
GenderFemale
Credentials PSYD
Sole proprietorNo
NPI enumeratedJune 26, 2022
Last updated in NPPESOctober 21, 2025
Certification dateOctober 21, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCLINICAL PSYCHOLOGIST
Medical schoolOTHER
Graduated 2024 (2 years in practice)
Group practice The Commonwealth Of Massachusetts — 144 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Boston