Jerriod Nicholas Broadnax in Fayetteville - Counselor
Jerriod Nicholas Broadnax - NPI 1427116581
Jerriod Nicholas Broadnax is a Counselor in Fayetteville, Arkansas. Jerriod Nicholas Broadnax practices all healthcare services and medical treatments related to Counselor. The NPI Number for Jerriod Nicholas Broadnax is 1427116581. The last update date is 2021-08-10.
Jerriod Nicholas Broadnax's current location address is 509 E. Milsap Road, Fayetteville, Arkansas. You can contact this provider via phone number 4798797038 and fax number 4793400500. The mailing address for Jerriod Nicholas Broadnax is 509 E. Milsap Road, Fayetteville, Arkansas. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Jerriod Nicholas Broadnax |
|---|---|
| Address | 509 E. Milsap Road, Fayetteville, Arkansas |
| Phone Number | 4798797038 |
| Fax Number | 4793400500 |
| Sole Proprietor | Y |
| Credentials | LADAC, NCA |
NPI Number Detail
| NPI Number | 1427116581 |
|---|---|
| Provider Enumeration Date | 2006-12-04 |
| Last Updated Date | 2021-08-10 |
Provider Mailing Address Detail
| Address | 509 E. Milsap Road |
|---|---|
| City | Fayetteville |
| State | Arkansas (AR) |
| Post Code | 72703 |
| Phone Number | 4798797038 |
| Fax Number | 4793400500 |
Provider's Primary Taxonomy Detail
| Speciality | Counselor |
|---|---|
| Taxonomy | 101Y00000X |
| Licence No | 28533 |
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Definition: A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master's degree and clinical experience and supe |
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What is the unique 10-digit identifier code assigned to Jerriod Nicholas Broadnax by the Centers for Medicare & Medicaid Services?
The Jerriod Nicholas Broadnax has been issued the NPI (National Provider Identifier) 1427116581 by the CMS (Centers for Medicare & Medicaid Services), which serves as a unique identification number for healthcare providers.
Could you share the physical location details of Jerriod Nicholas Broadnax?
The Jerriod Nicholas Broadnax is situated at 509 E. Milsap Road, in the city of Fayetteville, state of AR, with the zip code 72703.
What is the area of specialization for Jerriod Nicholas Broadnax, and what is the corresponding taxonomy classification code for this field?
The specialized field of practice for Jerriod Nicholas Broadnax is Counselor, and the corresponding taxonomy code that categorizes this area of expertise is 101Y00000X.
On what date was the 1427116581 assigned to Jerriod Nicholas Broadnax?
The Jerriod Nicholas Broadnax was issued its 1427116581 on 2006-12-04, which is the date when this unique identifier was assigned to the organization by the Centers for Medicare & Medicaid Services.
As of what date were the Jerriod Nicholas Broadnax's details last updated?
The information pertaining to the Jerriod Nicholas Broadnax, including its address, specialty, and other details, was most recently updated on 2021-08-10.
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