Broken Roads Counseling LLC
Organization Active NPI Clinical Social Worker · Wellborn, FL
NPI 1487494191 · NPPES record last updated May 30, 2024
Key facts
- NPI
- 1487494191
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Clinical Social Worker 1041C0700X
- Legal business name
- BROKEN ROADS COUNSELING LLC
- Practice address
- 3519 168TH St
Wellborn, FL 32094-3017 - Phone
- (386) 249-5976
- NPI assigned
- May 30, 2024
- Organization subpart
- No
Authorized official
- Name
- Stacy Brandon, LCSW
- Title
- Owner
- Phone
- (386) 249-5976
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker |
1041C0700X | Yes |
Addresses
Primary practice location
3519 168TH St
Wellborn, FL 32094-3017
Mailing address
3519 168TH St
Wellborn, FL 32094-3017
Phone (386) 249-5976
Other providers in Wellborn, FL
All providers in Wellborn, FL · Clinical Social Worker in Florida
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 30, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.