Breaking Dawn LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

BREAKING DAWN LLC

Practice address

116 Wilkerson Ave
Madison, AL 35756-4280

Phone

(256) 490-4443

Fax

(256) 262-4637

NPI assigned

Mar 22, 2018

Organization subpart

No

Name

Misty Deramus, LICSWNPI 1477626471

Title

Owner/Clinical Social Worker

Phone

(256) 490-4443

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Misty McCants Deramus, LCSW

  • Clinical Social Worker
  • Madison, AL
  • NPI 1477626471
  NPD (past) Authorized official

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Mar 22, 2018.

{
    "created_epoch": "1521676800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1521676800000",
    "number": "1245734342",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "116 WILKERSON AVE",
            "city": "MADISON",
            "state": "AL",
            "postal_code": "357564280",
            "telephone_number": "256-490-4443"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "116 WILKERSON AVE",
            "city": "MADISON",
            "state": "AL",
            "postal_code": "357564280",
            "telephone_number": "256-490-4443",
            "fax_number": "256-262-4637"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BREAKING DAWN LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-03-22",
        "last_updated": "2018-03-22",
        "status": "A",
        "authorized_official_last_name": "DERAMUS",
        "authorized_official_first_name": "MISTY",
        "authorized_official_title_or_position": "OWNER/CLINICAL SOCIAL WORKER",
        "authorized_official_telephone_number": "256-490-4443",
        "authorized_official_credential": "LICSW"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Emily Kate Brannon
• Jeffrey D Brassart, M.D.
• Magdaline Hicks Braxton, LMFT
• Bryan Brazelle
• Dagan M Breakfield III, CRNP
• Maegan Brecher, LMSW
• Sara Breslin, MS, ATC
• Ameravathy M Brewer
• Shayla Michelle Brewton
• Isabella Laine Bridges

• All providers in Madison, AL
• Community/Behavioral Health Agency in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2018; 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.