Broadstreet Counseling Services LLC

Primary specialty

Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X

Legal business name

BROADSTREET COUNSELING SERVICES LLC

Practice address

2919 Telegraph Ave Apt 303
Oakland, CA 94609-3577

Phone

(313) 704-4217

NPI assigned

Nov 14, 2022

Last updated

Nov 14, 2022By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Brandon Haygood, LCSWNPI 1003299835

Title

Therapist

Phone

(313) 704-4217

Specialties & licenses 3

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Brandon Haygood

  • Social Worker
  • Decatur, GA
  • NPI 1003299835
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1668384000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1668384000000",
    "number": "1053029561",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2919 TELEGRAPH AVE APT 303",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946093577",
            "telephone_number": "313-704-4217"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2919 TELEGRAPH AVE APT 303",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946093577",
            "telephone_number": "313-704-4217"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BROADSTREET COUNSELING SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-11-14",
        "last_updated": "2022-11-14",
        "certification_date": "2022-11-14",
        "status": "A",
        "authorized_official_last_name": "HAYGOOD",
        "authorized_official_first_name": "BRANDON",
        "authorized_official_title_or_position": "THERAPIST",
        "authorized_official_telephone_number": "313-704-4217",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ralyn Mahinay Britton
• Samantha Xitlaly Brizuela
• Ronald Hayes Broach Sr.
• Victoria Broach
• Ethan Taylor Broadhead, RN
• Cassandra Broadway
• Marie Broadway
• Nataja Broadway
• Autumn J Broady, M.D., M.P.H.
• Victor Albert Brochard, M.D.

• Adult Mental Health Clinic/Center in Oakland, CA
• Providers in Oakland, CA by specialty
• Adult Mental Health Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.