Malcolm L Broadnax

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

LCA3486 Issued in MD

Practice address

4412 Cole Farm Rd
Nottingham, MD 21236-2961

Phone

(443) 528-0822

NPI assigned

Jun 11, 2024

Sex

Male

Sole proprietor

No

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

Enrolled in MD

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Mental Health Counselor

Education

Other, 2022

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Awake & Rooted Wellness & Recovery, LLC

  • Addiction (Substance Use Disorder) Counselor
  • Nottingham, MD
  • NPI 1407740582
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1718064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749600000000",
    "number": "1457193278",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2710 PELHAM AVE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212131119",
            "telephone_number": "443-528-0822"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4412 COLE FARM RD",
            "city": "NOTTINGHAM",
            "state": "MD",
            "postal_code": "212362961",
            "telephone_number": "443-528-0822"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROADNAX",
        "first_name": "MALCOLM",
        "middle_name": "L",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-06-11",
        "last_updated": "2025-06-11",
        "certification_date": "2025-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MD",
            "license": "LGP14898",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "MD",
            "license": "LCA3486",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ladamoneek Brennan
• Joshua Brenner
• Bridging Gaps Through Positive Solutions
• Bridging Gaps Through Positive Solutions
• Tara Brightbill, M.A., BCBA
• Miasia Brooks
• Christina Margaret Brown, MD
• Eariona Brown
• Nicole Brown
• Ronnie J Brown, LMSW

• Addiction (Substance Use Disorder) Counselor in Nottingham, MD
• Providers in Nottingham, MD by specialty
• Addiction (Substance Use Disorder) Counselor in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.