Broaddus Empowerment Community Services

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

BROADDUS EMPOWERMENT COMMUNITY SERVICES

Practice address

2101 E 142ND Ave Apt 102
Tampa, FL 33613-3629

Phone

(215) 876-2802

NPI assigned

Dec 14, 2022

Last updated

Dec 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

Elliott Wardrick, MSWLMHPR

Title

Ceo

Phone

(804) 217-4806

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1670976000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1670976000000",
    "number": "1376255919",
    "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 COMMUNITY SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-12-14",
        "last_updated": "2022-12-14",
        "certification_date": "2022-12-14",
        "status": "A",
        "authorized_official_last_name": "WARDRICK",
        "authorized_official_first_name": "ELLIOTT",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "804-217-4806",
        "authorized_official_credential": "MSWLMHPR"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Briut Massage & Therapy Center
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• Yuneisy Brizuela
• Jamie Broach
• Stephanie Ann Broadaway, LCSW
• Broaddus Empowerment LLC
• Damaris Nicole Broadnax I
• Lindsey Nicole Broadnax, PA
• Yaima Broche Rodriguez
• Lavee Veronica Broche

• Community/Behavioral Health Agency in Tampa, FL
• Providers in Tampa, FL by specialty
• Community/Behavioral Health Agency in Florida

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