Kristen Gaylor Broyles, LPC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

LPC009961 Issued in GA

Practice address

105 Redmond Rd NW
Rome, GA 30165-1535

Phone

(706) 767-1421

NPI assigned

Mar 7, 2019

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Renewed Foundations Counseling Services

  • Mental Health Counselor
  • Rome, GA
  • NPI 1225758485
  NPD Authorized official
• Balanced Living Counseling Center

  • Mental Health Counselor
  • Rome, GA
  • NPI 1033656731
  NPD

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

{
    "created_epoch": "1551916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667088000000",
    "number": "1306304464",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 SOUTH AVE SW",
            "city": "ROME",
            "state": "GA",
            "postal_code": "301654217",
            "telephone_number": "706-767-1421"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 REDMOND RD NW",
            "city": "ROME",
            "state": "GA",
            "postal_code": "301651535",
            "telephone_number": "706-767-1421"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "108 E 5th Ave Ste B",
            "address_purpose": "LOCATION",
            "city": "Rome",
            "state": "GA",
            "postal_code": "301613128",
            "country_code": "US",
            "telephone_number": "706-509-0130",
            "fax_number": "706-237-6503",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BROYLES",
        "first_name": "KRISTEN",
        "middle_name": "GAYLOR",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-03-07",
        "last_updated": "2022-10-30",
        "certification_date": "2022-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "GA",
            "license": "LPC009961",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "GA",
            "license": "LPC009961",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rmanada Brown, APRN
• Stephen Lawrence Brown, MD
• Sue Chandler Brown, RD
• Tabitha Brown
• Tamara Tanique Brown, MD
• McKenzi Paige Brumby, WHNP-BC
• Starla Kay Brumit Chandler, NP-C
• Ashley Eugenia Bryan, DNP
• Cynthia Bryan, RN
• Edward Gerard Buckenham III, MA, LPC

• Mental Health Counselor in Rome, GA
• Providers in Rome, GA by specialty
• Mental Health Counselor in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 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.