Active NPI
Broaddus Empowerment LLC
- Community/Behavioral Health Agency
- Tampa, FL
National Provider Identifier
1023880978
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Behavioral Health Agency
- Legal business name
- BROADDUS EMPOWERMENT LLC
- Practice address
- 2101 E 142ND Ave Apt 102
Tampa, FL 33613-3629 - Phone
- (215) 876-2802
- NPI assigned
- Oct 24, 2023
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Robbin Garrett
- Title
- Owner
- Phone
- (813) 475-0847
Specialties & licenses 15
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | |||
| Addiction (Substance Use Disorder) Psychologist | 103TA0400X | |||
| Adult Development & Aging Psychologist | 103TA0700X | |||
| Clinical Child & Adolescent Psychologist | 103TC2200X | |||
| Nutrition Education Nutritionist | 133NN1002X | |||
| Case Manager/Care Coordinator | 171M00000X | |||
| Local Education Agency (LEA) | 251300000X | |||
| Case Management Agency | 251B00000X | |||
| Community/Behavioral Health Agency | 251S00000X | Primary | ||
| Mental Health Clinic/Center (Including Community Mental Health Center) | 261QM0801X | |||
| Adult Mental Health Clinic/Center | 261QM0850X | |||
| Adolescent and Children Mental Health Clinic/Center | 261QM0855X | |||
| Substance Abuse Rehabilitation Facility | 324500000X | |||
| Children's Substance Abuse Rehabilitation Facility | 3245S0500X | |||
| Transportation Network Company | 342000000X |
Addresses
Primary practice location
2101 E 142ND Ave Apt 102
Tampa, FL 33613-3629
Mailing address
2101 E 142ND Ave Apt 102
Tampa, FL 33613-3629
Phone (215) 876-2802
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1698105600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1698105600000",
"number": "1023880978",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2101 E 142ND AVE APT 102",
"city": "TAMPA",
"state": "FL",
"postal_code": "336133629",
"telephone_number": "215-876-2802"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2101 E 142ND AVE APT 102",
"city": "TAMPA",
"state": "FL",
"postal_code": "336133629",
"telephone_number": "215-876-2802"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "BROADDUS EMPOWERMENT LLC",
"organizational_subpart": "NO",
"enumeration_date": "2023-10-24",
"last_updated": "2023-10-24",
"certification_date": "2023-10-24",
"status": "A",
"authorized_official_last_name": "GARRETT",
"authorized_official_first_name": "ROBBIN",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "813-475-0847"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Counselor, Mental Health",
"state": null,
"license": null,
"primary": false
},
{
"code": "103TA0400X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Psychologist, Addiction (Substance Use Disorder)",
"state": null,
"license": null,
"primary": false
},
{
"code": "103TA0700X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Psychologist, Adult Development & Aging",
"state": null,
"license": null,
"primary": false
},
{
"code": "103TC2200X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Psychologist, Clinical Child & Adolescent",
"state": null,
"license": null,
"primary": false
},
{
"code": "133NN1002X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Nutritionist, Nutrition, Education",
"state": null,
"license": null,
"primary": false
},
{
"code": "171M00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Case Manager/Care Coordinator",
"state": null,
"license": null,
"primary": false
},
{
"code": "251300000X",
"taxonomy_group": "",
"desc": "Local Education Agency (LEA)",
"state": null,
"license": null,
"primary": false
},
{
"code": "251B00000X",
"taxonomy_group": "",
"desc": "Case Management",
"state": null,
"license": null,
"primary": false
},
{
"code": "251S00000X",
"taxonomy_group": "",
"desc": "Community/Behavioral Health",
"state": null,
"license": null,
"primary": true
},
{
"code": "261QM0801X",
"taxonomy_group": "",
"desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
"state": null,
"license": null,
"primary": false
},
{
"code": "261QM0850X",
"taxonomy_group": "",
"desc": "Clinic/Center, Adult Mental Health",
"state": null,
"license": null,
"primary": false
},
{
"code": "261QM0855X",
"taxonomy_group": "",
"desc": "Clinic/Center, Adolescent and Children Mental Health",
"state": null,
"license": null,
"primary": false
},
{
"code": "324500000X",
"taxonomy_group": "",
"desc": "Substance Abuse Rehabilitation Facility",
"state": null,
"license": null,
"primary": false
},
{
"code": "3245S0500X",
"taxonomy_group": "",
"desc": "Substance Abuse Rehabilitation Facility, Substance Abuse Treatment, Children",
"state": null,
"license": null,
"primary": false
},
{
"code": "342000000X",
"taxonomy_group": "",
"desc": "Transportation Network Company",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Tampa, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.